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. 2019 Jul 1;125(13):2291-2299.
doi: 10.1002/cncr.32040. Epub 2019 Mar 22.

Long-term fatigue in survivors of non-Hodgkin lymphoma: The Lymphoma Study Association SIMONAL cross-sectional study

Nicolas Mounier  1 , Sabine Anthony  2 , Raphaël Busson  3   4 , Catherine Thieblemont  5 , Vincent Ribrag  6 , Hervé Tilly  7 , Corinne Haioun  8 , René-Olivier Casasnovas  9 , Franck Morschhauser  10 , Pierre Feugier  11 , Richard Delarue  12 , Loic Ysebaert  13 , Catherine Sebban  14 , Florence Broussais-Guillaumot  15 , Gandhi Damaj  16 , Virginie Nerich  17 , Jean-Philippe Jais  18 , Lilian Laborde  19 , Gilles Salles  20   21 , Michel Henry-Amar  4
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Free article

Long-term fatigue in survivors of non-Hodgkin lymphoma: The Lymphoma Study Association SIMONAL cross-sectional study

Nicolas Mounier et al. Cancer. .
Free article

Abstract

Background: Long-term survivors of non-Hodgkin lymphoma (NHL) must cope with treatment complications and late toxicities that affect their health-related quality of life. Little is known about the risk-to-benefit ratio of new agents like rituximab. The impact of treatment regimens and health disorders on long-term fatigue levels was investigated in a cross-sectional study.

Methods: Two self-administered questionnaires, the 20-item Multidimensional Fatigue Inventory (MFI-20) and a Life Situation Questionnaire, were mailed in 2015 to NHL survivors enrolled onto 12 successive clinical studies (1993-2010) conducted by the Lymphoma Study Association. Private addresses were obtained for 3317 survivors, of whom 1671 (50%) returned the questionnaires. Severe fatigue was defined as MFI-20 scores ≥60 on dimension scales scored from 0 to 100. Linear regression models were used to assess factors that were linked to increased fatigue levels.

Results: The study population included 906 men and 765 women, and the median age was 64 years (age range, 24-95 years). Overall, 811 survivors had received cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP)-like chemotherapy, 518 had received high-dose CHOP, and 342 had undergone upfront autologous stem cell transplantation; 829 survivors also had received rituximab. In total, 1100 survivors (66%) reported 1 or more late health disorders. Severe fatigue was reported by 602 survivors (37%). Increased fatigue levels were associated (P < .001) with increased age, obesity, and the presence of health disorders, but not with initial treatment or rituximab.

Conclusions: The survey confirms that high proportions long-term NHL survivors have severe fatigue. The results suggest that initial treatment and the receipt of rituximab have no influence on the development of long-term fatigue.

Keywords: cross-sectional study; long-term fatigue; long-term survivors; non-Hodgkin lymphomas; risk factors.

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