Health related quality of life (HRQoL) in survivors of lymphoma: a systematic review and methodological critique

Abstract

Survival rates for Hodgkin’s Disease and Non-Hodgkin’s Lymphoma have improved in recent years. However, these improvements are associated with various late effects, which can compromise health-related quality of life (HRQoL). Assessment is essential to identify patients at most risk for compromised HRQoL , but is dependent on availability of reliable and sensitive measures. This review therefore aimed to: (i) identify and evaluate commonly used measures; (ii) compare HRQoL in lymphoma patients with the general population; (iii) assess the impact of different treatments on HRQoL; and (iv) identify associations between HRQoL and demographic, medical and psychological variables. Standardized systematic searches identified 18 eligible studies which reported quantitative results by histologic diagnosis and included adult survivors of lymphoma. Information about design, sample, measures and findings was extracted from each study. The SF-36 and the EORTC QLQ-C30 were the most commonly used measures. Survivors of lymphoma experienced worse physical but comparable mental HRQoL to the general population. No conclusions could be drawn about the effects of different treatments on HRQoL. Correlates of better HRQoL included younger age (physical), educational level, being employed, male gender, earlier stage disease, not having co-morbid illnesses, and meeting public health exercise guidelines. Limitations of current research relating to research design, sample demographics and reporting of descriptive statistics were identified. Given the increasing numbers of patients living with lymphoma, controlled studies using cancer-specific instruments are required to determine the extent of physical and psychological consequences associated with the condition

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