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Review
. 2021 Jul 7;13(14):3401.
doi: 10.3390/cancers13143401.

Late Neurological and Cognitive Sequelae and Long-Term Monitoring of Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma Survivors: A Systematic Review by the Fondazione Italiana Linfomi

Silvia Franceschetti  1 , Maria Antonietta Annunziata  2 , Giulia Agostinelli  2 , Chiara Gerardi  3 , Eleonora Allocati  3 , Carla Minoia  4 , Attilio Guarini  4
Affiliations
Review

Late Neurological and Cognitive Sequelae and Long-Term Monitoring of Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma Survivors: A Systematic Review by the Fondazione Italiana Linfomi

Silvia Franceschetti et al. Cancers (Basel). .

Abstract

Background: The continuously improving treatment outcome for classical Hodgkin lymphoma (cHL) and diffuse large B-cell lymphoma (DLBCL) over the last 25 years has led to a high number of long-term survivors. The impact of treatment, however, can sometimes be dramatic and long-lasting. Focusing on peripheral neuropathy (PN), cognitive impairment, fatigue, anxiety, and depression, researchers of the Fondazione Italiana Linfomi conducted a systematic review of the literature to collect the available data on sequelae incidence as well as evidence of follow-up strategies for long-term cHL and DLBCL survivors.

Methods: The review was carried out under the methodological supervision of the Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy. The literature search was conducted on three databases (MEDLINE, Embase, and the Cochrane Library) updated to November 2019. The selection process and data extraction were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results: A total of 2236 abstracts were screened, 247 full texts were analyzed, and 35 papers were included in the final analysis. Fatigue was the most extensively studied among neuropsychological sequelae, with a mean prevalence among cHL survivors of 10-43%. Although many of the papers showed an increased incidence of PN, cognitive impairment, and anxiety and depression in long-term cHL and DLBCL survivors, no definite conclusions can be drawn because of the methodological limitations of the analyzed studies. No data on monitoring and follow-up strategies of PN and other neuropsychological sequelae were highlighted.

Conclusions: Based on our findings, future studies in this setting should include well-defined study populations and have a longitudinal trial design to assess the outcomes of interest over time, thus as to structure follow-up programs that can be translated into daily practice.

Keywords: anxiety; classical Hodgkin lymphoma; cognitive impairment; depression; diffuse large B-cell lymphoma; fatigue; neuropathy; quality of life; survivors; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram on peripheral neuropathy.
Figure 2
Figure 2
PRISMA flow diagram on the efficacy of follow-up programs for the diagnosis and management of peripheral neuropathy.
Figure 3
Figure 3
PRISMA flow diagram on the incidence of cognitive impairment.
Figure 4
Figure 4
PRISMA flow diagram on the efficacy of follow-up programs for the diagnosis and management of cognitive impairment.
Figure 5
Figure 5
PRISMA flow diagram on the incidence of fatigue.
Figure 6
Figure 6
PRISMA flow diagram on the incidence of anxiety and depression.
Figure 7
Figure 7
PRISMA flow diagram on the efficacy of follow-up programs for the diagnosis and management of anxiety and depression.
See this image and copyright information in PMC

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