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Long‐term fatigue in survivors of non‐Hodgkin lymphoma: The Lymphoma Study Association SIMONAL cross‐sectional study
Author(s) -
Mounier Nicolas,
Anthony Sabine,
Busson Raphaël,
Thieblemont Catherine,
Ribrag Vincent,
Tilly Hervé,
Haioun Corinne,
Casasnovas RenéOlivier,
Morschhauser Franck,
Feugier Pierre,
Delarue Richard,
Ysebaert Loic,
Sebban Catherine,
BroussaisGuillaumot Florence,
Damaj Gandhi,
Nerich Virginie,
Jais JeanPhilippe,
Laborde Lilian,
Salles Gilles,
HenryAmar Michel
Publication year - 2019
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.32040
Subject(s) - medicine , chop , rituximab , prednisone , quality of life (healthcare) , vincristine , lymphoma , cross sectional study , population , cyclophosphamide , physical therapy , pediatrics , chemotherapy , pathology , environmental health , nursing
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.