Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

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doi: 10.17219/acem/151640

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Language: English

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Szeja NE, Grosicki S. Quality of life in patients with lymphoproliferative neoplasms at diagnosis and after the first-line treatment [published online as ahead of print on August 11, 2022]. Adv Clin Exp Med. 2022. doi:10.17219/acem/151640

Quality of life in patients with lymphoproliferative neoplasms at diagnosis and after the first-line treatment

Nicola Elżbieta Szeja1,A,B,C,D, Sebastian Grosicki1,E,F

1 Department of Hematology and Cancer Prevention, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Poland

Abstract

Background. The assessment of the quality of life (QoL) in hematology-oncology patients is extremely important. The disease and anti-cancer therapy can cause adverse effects, directly impacting the physical and mental condition of the patient and indirectly influencing their social and professional situation. Therefore, a properly performed QoL assessment should take into account all of these aspects. Moreover, QoL assessment has a prognostic value in regard to treatment success and prognosis; therefore, the improvement in the QoL is often one of the goals of therapy.
Objectives. To identify the changes in QoL during therapy in patients with lymphoproliferative neoplasms.
Material and Methods. Forty-six hematology-oncology patients participated in this prospective single-center study. Their QoL was analyzed at 2 time points (before and after the first-line treatment). For this purpose, the EORTC QLQ-C30 questionnaire was used. All statistical analyses were performed using the STATISTICA v. 13 software. A value of p < 0.05 was considered statistically significant.
Results. The study included patients with multiple myeloma (MM; 47.8%), non-Hodgkin lymphoma (NHL; 28.3%) and chronic lymphocytic leukemia (CLL; 23.9%). After the first line of treatment, patients perceived their overall QoL as slightly better than before starting the treatment, with an average increase of 1.94. Statistically significant differences were observed in physical and emotional functioning as well as fatigue, pain, dyspnea, appetite, and constipation.
Conclusion. In patients with lymphoproliferative neoplasms, after the first-line treatment, an improvement in an overall QoL and level of functioning, as well as a reduction in the severity of symptoms were observed.

Key words

quality of life, chemotherapy, lymphoproliferative neoplasms

Tables


Table 1. Description of questions included in the EORTC QLQ-C30 questionnaire (own elaboration based on the studies)19, 24

Scale

Abbreviation

Item numbers

Number of items

Item range*

Functional scales

Physical functioning

PF

1–5

5

3

Role functioning

RF

6, 7

2

3

Emotional functioning

EF

21–24

4

3

Cognitive functioning

CF

20, 25

2

3

Social functioning

SF

26, 27

2

3

Symptom scales

Fatigue

FA

10, 12, 18

3

3

Nausea and vomiting

NV

14, 15

2

3

Pain

PA

9, 19

2

3

Symptom items

Dyspnea

DY

8

1

3

Insomnia

SL

11

1

3

Appetite loss

AP

13

1

3

Constipation

CO

16

1

3

Diarrhea

DI

17

1

3

Financial difficulties

FI

28

1

3

Global health status/QoL

QL

29, 30

2

6

* Item range indicates the difference between the possible maximum and minimum response to individual items. EORTC QLQ-C30 – European Organisation for Research and Treatment of Cancer quality of life questionnaire; QoL – quality of life.
Table 2. General characteristics of the study group

Parameters

Value

Age [years], mean (±SD)

59.5 (±15.3)

Age [years], median (range)

62 (19–81)

Time duration of treatment [days], mean (±SD)

118 (±48.8)

Gender

Female, n (%)

16 (35.0)

Male, n (%)

30 (65.0)

Education

Primary, n (%)

6 (13.0)

Basic vocational, n (%)

14 (30.4)

Secondary, n (%)

16 (34.8)

Higher, n (%)

10 (21.8)

Place of residence

City, n (%)

42 (91.3)

Village, n (%)

4 (8.7)

Living with the family

Yes, n (%)

41 (89.1)

No, n (%)

5 (10.9)

Multiple diseases

Yes, n (%)

28 (60.9)

No, n (%)

18 (39.1)

SD – standard deviation.
Table 3. Parameters of the quality of life and functional scales before and after the first-line treatment

Scale

Before treatment

After first-line treatment

p-value*

M ±SD

Me

Q1

Q3

M ±SD

Me

Q1

Q3

QL

60.74 ±15.95

58.33

50.00

75.00

62.68 ±16.73

58.33

58.33

175.00

0.1224

PF

81.59 ±14.14

80.00

80.00

86.67

88.55 ±15.76

93.33

86.67

100.00

0.0004

RF

69.20 ±24.84

66.67

66.67

100.00

72.07 ±22.76

75.00

66.67

100.00

0.1006

EF

71.38 ±12.99

75.00

66.67

83.33

83.88 ±12.47

83.33

83.33

91.67

0.0003

CF

82.97 ±17.39

83.33

66.67

100.00

84.78 ±14.83

83.33

83.33

100.00

0.1219

SF

72.83 ±16.98

66.67

66.67

83.33

74.07 ±18.13

75.00

66.67

100.00

0.1337

* Wilcoxon test; M – mean; SD – standard deviation; Me – median; Q1 – 1st quartile; Q3 – 3rd quartile; QL – global health status/quality of life (QoL); PF – physical functioning; RF – role functioning; EF – emotional functioning; CF – cognitive functioning; SF – social functioning.
Table 4. Parameters of symptom scales and items before and after the first-line treatment

Scale

Before treatment

After first-line treatment

p-value*

M ±SD

Me

Q1

Q3

M ±SD

Me

Q1

Q3

FA

21.26 ±18.27

11.11

11.11

22.22

32.13 ±16.27

33.33

22.22

33.33

0.0004

NV

9.42 ±12.98

0.00

0.00

16.67

11.44 ±15.37

0.00

0.00

16.67

0.4445

PA

25.14 ±14.15

22.22

16.67

50.00

10.94 ±13.03

0.00

0.00

33.33

0.0002

DY

18.12 ±26.02

0.00

0.00

33.33

9.42 ±12.95

0.00

0.00

0.00

0.0001

SL

15.94 ±18.24

0.00

0.00

33.33

11.59 ±18.88

0.00

0.00

33.33

0.3612

AP

23.91 ±24.00

33.33

0.00

33.33

12.42 ±15.17

0.00

0.00

33.33

0.0003

CO

18.12 ±16.79

33.33

0.00

33.33

8.70 ±14.80

0.00

0.00

33.33

0.0116

DI

11.59 ±17.52

0.00

0.00

33.33

9.97 ±17.48

0.00

0.00

0.00

0.4567

FI

8.87 ±12.80

0.00

0.00

33.33

11.32 ±14.27

0.00

0.00

33.33

0.1821

* Wilcoxon test; M – mean; SD – standard deviation; Me – median; Q1 – 1st quartile; Q3 – 3rd quartile; FA – fatigue; NV – nausea and vomiting; PA – pain; DY – dyspnea; SL – insomnia; AP – appetite loss; CO – constipation; DI – diarrhea; FI – financial difficulties.

Figures


Fig. 1. Incidence of lymphoproliferative neoplasms in the study group
MM – multiple myeloma; CLL – chronic lymphocytic leukemia; NHL – non-Hodgkin lymphoma.
Fig. 2. Self-assessment of patients’ health before and after the first-line treatment

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