Quality of life key to lymphoma patients’ survival

Those with higher well-being more likely to live longer, study finds

SAN FRANCISCO— Self-reported quality of life among patients diagnosed with aggressive lymphoma can predict overall survival and event-free survival, a Mayo Clinic study has found. The results were presented at the 56th American Society of Hematology annual meeting in San Francisco.

“We studied a large sample of patients with aggressive lymphoma and found that their baseline quality of life is pre- dictive of overall survival and event-free survival, even after adjustment for known factors related to survival,” says the study’s lead author, Carrie Thompson, a hematologist at Mayo Clinic. “Our findings provide evidence that patientreported outcomes are as important as other more objective International Prognostic Indicators (IPI).” IPI is a clinical tool used to help predict the prognosis of patients with aggressive lymphoma.

Thompson and her colleagues followed 701 patients with aggressive lymphoma who completed baseline quality-of-life questionnaires between Sep- tember 2002 and December 2009. Baseline quality of life was measured using the Functional Assessment of Cancer Treatment- General scale (FACT-G), which measures four quality of life domains: physical, social/family, emotional and functional wellbeing. Measures also included a one-question linear analogue self-assessment for measuring overall quality of life and a linear analogue self-assessment measuring spiritual wellbeing.

Patients ranged from 18 to 92 years old with a median age of 62.

The median overall FACT-G total score was 83 and the median scores on the functional well-being, physical well-being, emotional well-being and social/family well-being were 18, 22, 18 and 25, respectively. Six per cent of patients reported a clinically deficient quality of life score on the FACT-G, defined as less than 50 on a 0 to 100 scale. When comparing qualityof-life scores between patients who were on active therapy to patients who were not yet treated, physical well-being, functional well-being and total FACT-G were lower in patients who were already on active treatment.

Thompson and her colleagues found that all quality-of-life measures but emotional wellbeing were significantly associated with overall survival. They also found that all measures but the linear analogue self-assessment measuring spiritual wellbeing remained significant after adjusting for IPI and the non-Hodgkins lymphoma subtype. For overall survival, the strongest associations were with total FACT-G and functional well-being.

Thompson and her colleagues also found that the one-question linear analogue self-assessment for measuring overall quality of life was associated with overall survival.