Patient-reported symptom burden and health-related quality of life in patients with aggressive Non-Hodgkin lymphoma: a cross-sectional study.

BACKGROUND

Patient-reported health-related quality of life (HRQoL) impacted by symptom burden is predictive of overall survival in patients with aggressive Non-Hodgkin lymphoma (NHL).

METHOD

This cross-sectional study investigated the Core Symptoms Burden Set (CSBS) significantly affecting the HRQoL in patient with aggressive NHL and identify a single cutoff point to separate clinical difference. The MDASI-TCM and EQ-5D-5 L were used to assess the symptom (severity and interference) and HRQoL. The t test, chi-square test or Wilcoxon rank-sum test were used to determine differences in symptoms burden between during and after cancer therapies. A multivariate linear regression model was used to identify associations between the CSBS and HRQoL. Receiver operating characteristic curves were used to identify optimum cutoff point considered the grading scale (0 vs. 1-3) of the ECOG as the anchor.

RESULTS

Total 116 eligible patients with aggressive NHL were analyzed. The CSBS were disturbed sleep (47.4%), fatigue (44.3%), and difficulty remembering (40.9%). The EQ-5D index value ranged from - 0.294 to 1.0 and the median of EQ VAS was 80(Interquartile: 25). There were 22.4% of patients with "11111" health state. The CSBS demonstrated significantly influence in the physical function (B = 0.442, 95%CI 0.260-0.623, P < 0.001), psychological function (B = 0.674, 95%CI 0.495-0.853, P < 0.001), EQ-5D index value (B = -0.014, 95%CI [-0.027]-[-0.001], P = 0.033) and EQ VAS (B = -3.047, 95%CI [-5.028]-[-1.066], P = 0.003) for the patients with aggressive NHL. The best cutoff point of CSBS with significantly clinical difference was 2.50, with a sensitivity of 82.4% and specificity of 64.6%.

CONCLUSIONS

The Core Symptoms Burden Set of patients with aggressive NHL impacted their HRQoL significantly whose score of 2.50 or higher would be a potential preliminary indicator to be emphasized and intervened.