Table 1 Impact of haematological cancer on QoL or HRQoL
From: Haematological cancer and quality of life: a systematic literature review
Article | Design | Population | Disease status/treatment | Procedure | Psychometrics instruments | Results |
|---|---|---|---|---|---|---|
Cull et al.15 | Comparative | Test group: 91 patients: - 55 HL - 36 NHL No-test group:a 109 patientsb | Disease-free Chemotherapy | Patients completed the instruments and returned them with a form giving preferred times for objective testing | QLQ-C30 HADS MFI BMFQ Memory aids NART PASAT RBMT | Poor QoL in complainers of memory problems No-test group reported better cognitive functioning but more fatigue than the test group (U=2.0, P=0.05) Test group: 30% patients reported difficulty in concentrating, 52% in remembering things, 63%, memory impairment, 13% possible anxiety and 10% possible depression |
Zittoun et al.33 | Longitudinal | 179 acute leukaemia patients | Chemotherapy or BMT | T1: 1 day after the end of chemotherapy or BMT T2: 10 days later the end of chemotherapy T3: 21 days after the end of chemotherapy | QLQ-C30 HADS Leukaemia/BMT module | Lack of appetite (T1=64%, T2=53%, T3=49%; P=0.03), fever (T1=24%, T2=47%, T3=22%; P⩽0.001), nausea (T1=38%, T2=23%, T3=16%; P⩽0.001), vomiting (T1=35%, T2=17%, T3=16%; P⩽0.001), and hair loss (T1=19%, T2=54%, T3=60%; P⩽0.001) High frequency of anxiety and depression over time Trend to improvement at the end of treatment |
Heinonen et al.19 | Longitudinal | 109 patients: - 32 CML - 39 AML - 15 ALL - 13 MDS - 5 MM - 2 NHL - 2 AA - 1 myelofibrosis | Allogeneic BMT | T1: ⩽12 months after BMT T2: 12 to ⩽36 months after BMT T3: 36 to ⩽60 months after BMT T4: >60 months after BMT | FACT-BMT POMS ADL Scale MOS-SS SSQ6 | T1: worse perception of physical well-being (P=0.000, PV=20%), anxiety (⩽12: MS=9.8; s.d.=5.0; over 12: MS=7.6; s.d.=4.2; F= 4.1*) and mood disturbance (⩽12: MS=49.1; s.d.=25.0; F=4.8*) Deterioration of availability and satisfaction with social support Most of patients could carry on with their daily activities without any help Functional well-being negatively affected (T1=16.8%, T2=27.1%, T3=21.5%, T4=34.6%) because of lack of energy and sleeping disorders |
Persson et al.25 | Longitudinal | 16 patients: - 7 AL - 9 HML | Chemotherapy 7 patients had no relapse 6 patients had a relapse 3 patients died before remission | T1: start of treatment T2: 4 months after treatment T3: 8 months T4: 12 months T5: 16 months T6: 20 months T7: 24 months | QLQ-C30 | T1: Deterioration of QoL, role and social functioning (more important in AL than HML patients) with fatigue, dyspnoea and sleep disturbances Deterioration of QoL in patients with relapses than those without relapse T7: Deterioration of role, social, cognitive and emotional functioning and poor QoL, essentially in patients with relapses Deterioration of role and social functioning more important in AL than HML patients |
Wettergren et al.32 | Comparative | 357 subjects: - 121 HL survivors - 236 CG | Long-term survivors Radiation, chemotherapy or combined modality | Scales sent by postal mail Respondents were promised a movie ticket if they participated in the study | SEIQoL-DW | HL survivors reported leisure and finance less frequently than CG (leisure: HL survivors=31.4% and CG=47.9%; df=1; P=0.003; finance: HL survivors=29.8% and CG=41.5%; df=1; P=0.03) Fatigue, loss of energy in HL patients (10.7%; N=13 on 121; MS=3.0; s.d.=1.0) |
Sherman et al.29 | Pilot | 61 patients: - 52 MM - 5 MGUS - 4 amyloid | Patients newly admitted to the transplant programme Stage of diseases:c - 13 for the stage I - 10 for the stage II - 32 for the stage III - 6 unknown | Assessment prior to starting local protocols for conditioning and transplant | SF-12 POMS-F PG-SGA BPI HADS FACIT | Major symptoms: nutritional deficits, deterioration of physical functioning, fatigue and pain, emotional distress, disrupted sexual functioning and difficulties with body image |
Rüffer et al.26 | Comparative | 1753 subjects: - 818 HL survivors - 935 CG | Long-term survivors Radiotherapy, chemotherapy Combined modality treatment | In 1995, the authors had contacted 1981 patients, who were enrolled in the German Hodgkin Studies Patients with a current status of complete remission were contacted to participate in this study | QLQ-S QLQ-C30 LSQ MFI | All levels of fatigue are high even years after treatment and higher than those of the CG: GF: Patients: MS=37.6; s.d.=29.1/CG: MS=30.9; s.d.=23.2; P<0.001 PF: Patients: MS=32.6; s.d.=29.2/CG: MS=25.0; s.d.=24.2; P<0.001 RA: Patients: MS=28.0; s.d.=26.1/CG: MS=21.4; s.d.=21.8; P<0.001 MF: Patients: MS=26.6; s.d.=26.8/CG: MS=21.8; s.d.=23.5; P<0.001 RM: Patients: MS=19.8; s.d.=20.1/CG: MS=16.9; s.d.=18.1; P<0.001 Association between severe illnesses with fatigue |
Gulbrandsen et al.18 | Comparative | Data from two prospective Nordic Myeloma Study Group Trials: - 221 patients <60 years treated with high-dose chemotherapy - 203 patients >60 years treated with MP | Patients newly diagnosed with MM, with addition to low-dose IFN alpha 2b to conventional treatment with MP Comparison of results with the Norwegian population | Data obtained from prospective trials | QLQ-C30 | At diagnosis, most distressing problems: pain, fatigue, reduced physical functioning, limitations in role functioning and reduced QoL |
Frick et al.17 | Comparative | 46 MM 20 NHL 13 other diseasesd | Complete remission: 6 patients Partial remission: 52 patients No change: 15 patients Progressive disease: 1 patient Not available PBSCT: 5 patients | Randomisation: - individualised Psychodynamic short term Psychotherapy immediately after PBSCT until 6 months after PBSCT - from 6 months after PBSCT until 1 year after - to a CG receiving ‘treatment as usual’ | QLQ-C30 SEIQoL-DW | Most frequent domains nominated by the patients: family (89%), hobbies/pastimes (74%), physical health (mobility) (70%), profession/occupation (51%), social life/friends (47%) and partnership (33%) |
Merli et al.22 | Longitudinal | 91 aggressive NHL | Chemotherapy | T1: diagnosis and before treatment T2: during chemotherapy T3: 1 month after the end of chemotherapy | QLQ-C30 | T1: association between anaemia and poor QoL T2: improvements of QoL, pain (P=0.003), appetite (P=0.006), sleep (P=0.015) and GH (P=0.027), except diarrhoea and social activity T3: improvements of QoL (P=0.05), global health (P=0.011), appetite (P=0.0001), emotional functioning (P=0.01) and role (P=0.05), reductions of pain (P=0.02), sleep disorders (P=0.007) and constipation (P=0.04) |
Holzner et al.20 | Longitudinal | 76 CLL 152 HC | Chemotherapy | T1: baseline T2: 3 months after baseline T3: 6 months after baseline T4: 12 months after baseline | QLQ-C30 | Lower QoL in CLL patients compared with HC Physical functioning: effect size medium (ES −0.56; P<0.001) Role and cognitive functioning: effect size small (ES −0.43, P<0.01 and ES −0.27, P<0.1) More symptoms in CLL patients compared with HC: fatigue (ES 0.81), nausea and vomiting (0.69), constipation (0.69), appetite loss (0.68) and dyspnoea (0.44) Lower emotional and social QoL in female than in male patients |
Vallance et al.31 | Retrospective | 438 NHL survivors: - 255 indolent - 183 agressive | - 283 with chemotherapy - 68 with chemotherapy and radiation - 47 with radiation - 16 with surgery - 4 with immunotherapy - 36 with BMT | Questionnaire mailed to patients | FACT-An | Better QoL in NHL meeting public health exercise guidelines than NHL not meeting guidelines |
Santos et al.27 | Cross-sectional | 107 patients: - 54 NHL - 18 AML - 10 ALL - 25 MM | In treatment: - 42 with intravenous chemotherapy - 5 with oral medication - 5 with radiotherapy - 55 with monitoring | Instruments applied during face-to-face interviews | QLQ-C30 | Deterioration of QoL essentially in MM patients, contrary to patients with other cancers |
Mols et al.24 | Comparative | 116 long-term HL survivorse - 48 patients for the 5–9 year survivors - 68 patients for the 10–15 year survivors | Off-treatment | Survey conducted at the ECRf | SF 36 QoL-CS | Better QoL in patients diagnosed 10–15 years ago compared with patients 5–9 years ago Lower GH and lack of energy in patients diagnosed 10–15 years ago than patients diagnosed 5–9 years ago Lower general and mental health, social functioning and vitality in patients diagnosed 5–9 years ago, compared with normative sample |
Mols et al.23 | Comparative | 221 NHL Sample size for population is not specified | Long-term survivors (5–15 years postdiagnosis) | Recruited from the ECR | SF-36 QoL-CS | Patients diagnosed from 10 to 15 years earlier reported better psychological (β= 0.17*) and social (β= 0.21**) well-being than patients diagnosed from 5 to 9 years earlier Compared with population, patients reported worse GH (P<0.001), less vitality (P<0.001), higher scores for pain (P<0.001) and problems with work or obtaining health-care insurance and home mortgage |
Shanafelt et al.28 | Comparative | 1482 CLL | Majority of patients with low-stage disease at diagnosis 40.3% of patients with chemotherapy and/or monoclonal antibody | Between June and October 2006 | FACT-G BFI | QoL and social and functional dimensions were similar to or better than population norms QoL was worse in patients with advanced stage of disease Lower emotional well-being in CLL patients, compared with population and patients with other types of cancer |
Else et al.16 | Comparative | 431 CLL | Chemotherapy | Randomisation into the Leukaemia Research Fund CLL4 trial Instruments given at the start of chemotherapy | QLQ-C30 | Impaired HRQoL for the fatigue, sleep disturbance, role functioning and dyspnoea in CLL patients compared with population |
Strasser-Weippl and Ludwig13 | Randomized clinical trial | 92 MM | Chemotherapy | Questionnaires presented to patients during the first study visit of the clinical trial Conventional treatment | QLQ-C30 | Impairment of QoL at onset on therapy |
Courneya et al.14 | Longitudinal | 122 patients: - 52 indolent NHL - 48 aggressive NHL - 22 HL | 62 patients with UC 60 patients with AET | T0: baseline T1: postintervention T2: 6-month follow-up | FACT-An Happiness Scale Depression Short Form Center for Epidemiological Studies-Depression Scale STAI SF-12 | T1: better physical functioning (mean group difference, +9.0; CI=2.0 to 16.0; P=0.012), cardiovascular fitness (P<0.001), QoL (P=0.021), happiness (P=0.004) and GH (P<0.001) and attenuation of fatigue (P=0.013) and depression (P=0.005) in AET compared with UC patients T2: better happiness (P=0.034), and attenuation of depression (P=0.009) in AET, comparatively UC patients |
Johnsen et al.21 | Cross- sectional | 470 patients: - 34 AML - 132 CLL - 34 CML - 33 HL - 164 NHL - 54 MM - 19 ALL, myelofibrosis or unclassified leukaemia | - 269 patients had lymphoma stage 1 or 2 - 60 patients had inaccessible lymphoma stage - 99 patients had no treatment - 358 patients had active antineoplastic treatment | Scales, information letter and consent form send by mail | QLQ-C30 | Symptoms experienced by patients: fatigue (55%), insomnia (46%) and pain (37%) Impairments: role (49%) and physical functions (34%) More problems (physical, role, social functions, pain and constipation) in MM in comparison to other patients More reduced in physical (OR2=1.53; 95% CL= 1.36–1.74; P<0.001) and role functions (OR2=1.32; 95% CL= 1.16–1.51; P<0.001), constipation (OR2=1.47; 95% CL=1.22–1.78; P<0.001), appetite loss (OR2=1.28; 95% CL=1.08–1.51; P=0.004) and pain (OR2=1.28; 95% CL=1.13–1.45; P<0.001) in older patients, compared with younger patients, but less financial difficulties (OR2=0.76; 95% CL=0.65–0.89; P<0.001) in older patients More nausea (OR2=2.98; 95% CL=1.30–6.83; P=0.010) and appetite loss (OR2=3.14; 95% CL=1.33–7.41; P=0.009) in recently hospitalised patients than outpatients |
Smith et al.30 | Comparative | 761 NHL survivors: - 109 patients with ‘active disease’ - 150 ‘short-term survivors’ - 502 ‘long-term survivors’ | STS (2–4 years postdiagnosis) LTS (⩾5 years postdiagnosis) | Scales send by mail | SF-36 FACT-G FACT-LYM IOC Self-administered Comorbidity Questionnaire PTSD Checklist | Lower QoL, physical (mean (s.d.), 41.1 (11.9)) and mental health (mean (s.d.), 45.4 (11.5)) (all P⩽0.01) in individuals with active disease, compared with survivors |
