Longitudinal assessment of quality of life in indolent non-Hodgkin lymphomas managed with active surveillance

Abstract

There are limited data describing the impact of active surveillance on longitudinal health-related quality of life (HRQoL) in patients with indolent non-Hodgkin lymphomas (NHL). A cohort of untreated indolent NHL patients completed FACT-LYM questionnaires at 6, 12, 18, 24, and 36 months after diagnosis. Longitudinal FACT-LYM scores were analyzed by ANOVA and generalized linear mixed models. Indolent NHL scores were compared to norm general population scores. A total of 52 patients were identified, of which 46 (88%) remained on active surveillance at 36 months. There was no significant change in any of the FACT-LYM scores over 36 months. As compared to the general population, indolent NHL patients had higher, clinically meaningful scores in physical, functional, and social well-being, but not emotional well-being. Patients with indolent NHL on active surveillance have globally preserved HRQoL for up to 3 years after diagnosis. Emotional well-being continues to be an unmet need during active surveillance.

Keywords: Patient-reported outcomes; active surveillance; non-Hodgkin lymphoma; quality of life.

Figure 1.

Mean scores of Physical Well-Being (PWB), Functional Well-Being (FWB), Emotional Well-Being (EWB), Social Well-Being (SWB), and FACT-G total summary score (FACT-G TOT) of the active surveillance lymphoma cohort (black), general population norm cohort (blue), cancer population norm cohort (red), and ECOG 0 cancer population norm cohort (orange) at each timepoint from 6 through 36 months. Higher scores indicate a better quality of life. Statistically-significant differences between the lymphoma cohort and each population norm cohort is indicated with asterisks. Clinically-significant differences between the lymphoma cohort and each population norm cohort, based on the minimally important difference for each subscale, is indicated with a plus sign.