Health-related quality of life and its potential prognostic implications in patients with aggressive lymphoma - A Nordic lymphoma group trial

This study was conducted to explore treatment and disease-related effects o n health-related quality of life (HRQoL) in patients with aggressive lympho ma, to identify predictors for impaired long-term HRQoL, and to analyze the prognostic value of pretreatment HRQoL. Ninety-five patients with aggressi ve lymphoma, constituting a subset of a randomized multicenter trial compar ing CHOP and MACOP-B, entered a HRQoL study, using the EORTC QLQ-C30 questi onnaire. Patient scores were compared to scores from an age- and gender-adj usted reference population sample, and evaluation of the prognostic value o f pretreatment QoL scores in relation to clinical prognostic factors was pe rformed. Before treatment, patients exhibited lower scores of global QoL, p hysical, role, and social functions, and more appetite loss, compared to th e reference population. Role functioning improved compared to baseline, but remained depressed compared to the reference group more than 8 mo after en d of treatment. By then, the patient group displayed no difference in other HRQoL variables compared to that of the reference population. No reliable predictor for impaired long-term HRQoL could be identified. In multivariate analysis, including the factors of the International Prognostic Index, pre treatment global QoL was an independent prognostic marker for overall survi val. In conclusion, in this population with aggressive lymphoma and favorab le prognostic features, HRQoL was not substantially affected during the fir st year after diagnosis. Pretreatment global QoL may constitute a significa nt prognostic factor, meriting further investigation in prospective studies .