Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 178
Filtrar
1.
Eur J Cancer ; 208: 114210, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39002346

RESUMO

INTRODUCTION: Considering the notable advances made in the treatment of lymphoma, assessment of health-related quality of life (HRQoL) of lymphoma patients has become a critical aspect to consider both in clinical research and routine practice. However, there is paucity of information about lymphoma specific HRQoL profile at diagnosis. PATIENTS AND METHODS: HRQoL at diagnosis was assessed for 3922 adult patients with newly diagnosed high-grade (HG) (n = 1994), low-grade (LG) (n = 1053) non-Hodgkin (NHL) and Hodgkin (HL) (n = 875) lymphomas included in REal world dAta in LYmphoma and Survival in Adults (REALYSA, NCT03869619), a prospective non-interventional multicentric cohort in France. Disease-specific HRQoL aspects were assessed with three validated EORTC questionnaires, namely, the QLQ-NHL-HG29, the QLQ-NHL-LG20 and the QLQ-HL27, for patients with NHL-HG, NHL-LG and HL, respectively. RESULTS: We confirmed the high-level of completion of these questionnaires in REALYSA cohort, ranging from 84 % for QLQ-HG29 to 88 % for QLQ-HL27. The proportion of patients with impaired global health status was as follows: T-cell NHL, 67 %; diffuse large B-cell (DLBCL), 62 %; Burkitt, 61 %; HL, 53 %; marginal zone, 49 %; mantle cell, 48 %; follicular, 47 %. Multivariable regression analyses for DLBCL, follicular and HL showed that gender, performance status and B symptoms were independently associated with all HRQoL dimensions. However, a variable effect of age and stage were observed among these three subtypes. CONCLUSIONS: A comprehensive analysis was made describing the HRQoL profile of newly diagnosed patients with different types of lymphomas. Our data may help to enhance the interpretation of HRQoL results in future studies using the recently validated EORTC lymphoma specific questionnaires.


Assuntos
Doença de Hodgkin , Linfoma não Hodgkin , Qualidade de Vida , Humanos , Doença de Hodgkin/psicologia , Masculino , Feminino , Pessoa de Meia-Idade , Linfoma não Hodgkin/psicologia , França/epidemiologia , Adulto , Idoso , Estudos Prospectivos , Inquéritos e Questionários , Adulto Jovem , Adolescente , Nível de Saúde , Idoso de 80 Anos ou mais
2.
J Neuroimmunol ; 392: 578372, 2024 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-38788317

RESUMO

BACKGROUND AND PURPOSE: Immune dysfunction is one of the risk factors which plays an important role in the development of non-Hodgkin lymphoma (NHL), and inflammation may be involved in its etiology. Minimal data is available on the effect of cytokine levels on neurobehavioral function in lymphoma before the initiation of chemotherapy. Therefore, we aimed to explore the risk of NHL by assessment of cytokine and adipokine levels and their correlation with neurobehavioral changes. METHODS: This case-control study enrolled 62 subjects (age-sex matched: 31 cases and 31 controls). Neurobehavioral assessment was done using Montreal Cognitive Assessment questionnaire (MoCA) and Patient Health Questionnaire (PHQ-9). EORTC Core Quality of Life questionnaire (EORTC QLQ-C30) was used to assess quality of life. Questionnaire assessment and sample collection were done after the patient enrolment and before first cycle of chemotherapy. RESULTS: Mean age of NHL patients and healthy controls was 51.9 ± 11.8 and 50 ± 10.9 years, respectively. NHL patients showed significantly higher levels of IL-6 (0.77 ± 0.11) and TNF- α (1.47 ± 1.31) than controls (0.55 ± 0.4 and 0.66 ± 0.89, respectively) with p-value<0.005. Also, NHL patients showed significantly lower levels of adiponectin (0.31 ± 0.24) and omentin (0.46 ± 0.1) than controls (0.42 ± 0.13 and 0.53 ± 0.11, respectively) with p-value<0.005. Lower MoCA and EORTC QLQ C-30 scores and higher PHQ-9 scores were observed in NHL patients in comparison to healthy control. CONCLUSION: Our results showed that adiponectin, omentin IL-6 and TNF-α may be used as pre-diagnostic markers of NHL risk. Neurobehavioral changes observed in NHL patients may alter the quality of life.


Assuntos
Adiponectina , Citocinas , Proteínas Ligadas por GPI , Interleucina-6 , Lectinas , Linfoma não Hodgkin , Fator de Necrose Tumoral alfa , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Linfoma não Hodgkin/sangue , Linfoma não Hodgkin/psicologia , Linfoma não Hodgkin/complicações , Estudos de Casos e Controles , Adiponectina/sangue , Citocinas/sangue , Fator de Necrose Tumoral alfa/sangue , Adulto , Interleucina-6/sangue , Lectinas/sangue , Proteínas Ligadas por GPI/sangue , Depressão/sangue , Depressão/etiologia , Idoso , Qualidade de Vida , Transtornos Cognitivos/sangue , Transtornos Cognitivos/etiologia
3.
Eur J Oncol Nurs ; 70: 102619, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38797113

RESUMO

PURPOSE: Financial toxicity has emerged as a prevalent psychosocial problem in cancer patients, but data on non-Hodgkin lymphoma patients receiving chemotherapy remain limited. The present study aims to explore financial toxicity and its influencing factors among non-Hodgkin lymphoma patients. METHODS: A total of 236 non-Hodgkin lymphoma patients were enrolled from March to June 2023 in the oncology department of a tertiary grade-A hospital in China. Hierarchical regression analysis was used to analyze potential influences on financial, including general information, symptom burden, family and social support. RESULTS: The financial toxicity score for non-Hodgkin lymphoma patients was (19.24 ± 6.97). Among them, 92 participants (38.98%) were classified as experiencing high levels of financial toxicity, with a COST score of ≤17.5 points. Hierarchical regression analysis revealed that symptom burden accounting for 11.0% of the variance in financial toxicity, while family functioning and social support explained 5.8% and 4.9%, respectively. CONCLUSION: The financial toxicity of non-Hodgkin lymphoma patients needs to be further improved. Patients with low household income, unemployment, high symptom burden, and inadequate family and social support may experience severe financial toxicity. Financial toxicity of non-Hodgkin's lymphoma patients must be assessed and targeted interventions must be implemented to reduce their financial burden.


Assuntos
Efeitos Psicossociais da Doença , Linfoma não Hodgkin , Apoio Social , Humanos , Masculino , Linfoma não Hodgkin/economia , Linfoma não Hodgkin/psicologia , Feminino , Estudos Transversais , Pessoa de Meia-Idade , China/epidemiologia , Adulto , Idoso , Inquéritos e Questionários
4.
Eur J Oncol Nurs ; 69: 102540, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38461728

RESUMO

PURPOSE: This study aimed to explore the incidence and severity of vincristine-induced peripheral neuropathy (VIPN) in non-Hodgkin lymphoma (NHL) survivors (primary aim) and its impact on daily life by comparing common cancer symptoms, functional status, and quality of life (QoL) among survivors with acute, long-term, and non-VIPN (secondary aim). METHODS: This cross-sectional study examined 144 NHL survivors. Standardized questionnaires were used to assess common cancer symptoms, functional status, and QoL with the European Organization for the Research and Treatment of Cancer - Quality of Life Questionnaire (EORTC-QLQ-C30). VIPN (Chemotherapy-Induced Peripheral Neuropathy) status was classified using EORTC-QLQ-CIPN20. A self-designed interference scale was developed to determine the impact of the VIPN on daily activities. The Kruskal-Wallis test and Spearman rank correlation were used in this study. RESULTS: Among the survivors of acute and long-term VIPN, the highest incidences and most severe symptoms were found for hand numbness and foot cramps. A significant moderate correlation was found between disturbances in daily activities and acute or long-term VIPN, including gait changes, going up or down the stairs, and imbalance-related falls. Acute and long-term VIPN survivors showed worse symptoms (fatigue, insomnia, and constipation) and lower QoL than non-VIPN survivors did. In acute VIPN, social function was significantly affected, whereas in long-term VIPN, emotional and cognitive functions were affected. CONCLUSION: Numbness and cramps should be addressed in survivors of acute and long-term VIPN. Preventing falls is recommended for NHL survivors with VIPN, and psychological support is suggested for long-term VIPN survivors.


Assuntos
Linfoma não Hodgkin , Neoplasias , Doenças do Sistema Nervoso Periférico , Humanos , Vincristina/efeitos adversos , Qualidade de Vida/psicologia , Estudos Transversais , Estado Funcional , Hipestesia , Cãibra Muscular , Linfoma não Hodgkin/tratamento farmacológico , Linfoma não Hodgkin/psicologia , Sobreviventes , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Doenças do Sistema Nervoso Periférico/epidemiologia
5.
J Psychosoc Oncol ; 41(2): 235-241, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36815246

RESUMO

The purpose of this study was to explore whether patient-centered communication (PCC) would partially mediate the relationship between social support and mental health status among adult survivors of non-Hodgkin's lymphoma (NHL). Methods: Secondary analysis of self-administered questionnaires mailed to 682 adults with NHL who were assumed living and had completed the baseline 2005 study (83% response rate). Adult NHL survivors (n = 566) and data were analyzed using descriptive statistics and the Sobel test. Results: PCC partially mediated the relationship between social support and three measures of mental health outcomes (SF-36 Mental Component Summary [SF36-MCS], Post-Traumatic Stress Disorder Checklist-Civilian Version [PCL-C], Impact of Cancer - Negative Impact Summary [IOCv2 NIS]). Results of the conservative Sobel test were significant (p < .01) in three mediation models. Conclusions: Future research should focus on testing interventions that target PCC and identifying additional mediators and moderators between social support and mental health outcomes among cancer survivors.


Assuntos
Linfoma não Hodgkin , Qualidade de Vida , Adulto , Humanos , Qualidade de Vida/psicologia , Linfoma não Hodgkin/psicologia , Sobreviventes/psicologia , Apoio Social , Comunicação , Assistência Centrada no Paciente , Nível de Saúde
6.
Psychol Health Med ; 27(8): 1649-1660, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-33928815

RESUMO

Non-Hodgkin lymphoma (NHL) is a common haematological cancer that is comprised of approximately 30 subtypes, of which Waldenström Macroglobulinemia (WM) is a rare incurable form. It is typically managed using a watch-and-wait strategy that can contribute to illness uncertainty which may result in fear of cancer recurrence (FCR) and poor health-related quality of life (QOL). However, few studies have examined the correlates of FCR and QOL in NHL patients, including WM patients. One-hundred males and 92 females with a mean age of 62.7 years who were an average of 6.8 years from diagnosis completed the online questionnaire which asked about demographics, medical history, QOL, FCR, stress, anxiety and depression. Few NHL patients reported significant stress or affective distress, most had moderate-high QOL and 41% experienced recent FCR, relative to published cut-off scores. Poorer QOL was related to depression symptoms, FCR, higher illness burden (i.e. comorbidity) and fewer personal resources (i.e. unemployed), whereas FCR was related to shorter time since diagnosis and more depressive symptoms. Results suggest that FCR and depressive symptoms may adversely impact QOL, whereas a recent cancer diagnosis and depression-related pessimism may contribute to FCR.


Assuntos
Linfoma não Hodgkin , Qualidade de Vida , Medo/psicologia , Feminino , Humanos , Linfoma não Hodgkin/epidemiologia , Linfoma não Hodgkin/psicologia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/psicologia , Qualidade de Vida/psicologia , Sobreviventes/psicologia
7.
Biomed Res Int ; 2021: 9201235, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34337060

RESUMO

OBJECTIVES: Depression is highly prevalent in non-Hodgkin's lymphoma (NHL) patients undergoing chemotherapy. The social stress associated with malignancy induces neurovascular pathology promoting clinical levels of depressive symptomatology. The purpose of this study was to establish an effective depressive symptomatology risk prediction model to those patients. METHODS: This study included 238 NHL patients receiving chemotherapy, 80 of whom developed depressive symptomatology. Different types of variables (sociodemographic, medical, and psychosocial) were entered in the models. Three prediction models (support vector machine-recursive feature elimination model, random forest model, and nomogram prediction model based on logistic regression analysis) were compared in order to select the one with the best predictive power. The selected model was then evaluated using calibration plots, ROC curves, and C-index. The clinical utility of the nomogram was assessed by the decision curve analysis (DCA). RESULTS: The nomogram prediction has the most efficient predictive ability when 10 predictors are included (AUC = 0.938). A nomogram prediction model was constructed based on the logistic regression analysis with the best predictive accuracy. Sex, age, medical insurance, marital status, education level, per capita monthly household income, pathological stage, SSRS, PSQI, and QLQ-C30 were included in the nomogram. The C-index was 0.944, the AUC value was 0.972, and the calibration curve also showed the good predictive ability of the nomogram. The DCA curve suggested that the nomogram had a strong clinical utility. CONCLUSIONS: We constructed a depressive symptomatology risk prediction model for NHL chemotherapy patients with good predictive power and clinical utility.


Assuntos
Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Depressão/etiologia , Linfoma não Hodgkin/tratamento farmacológico , Linfoma não Hodgkin/psicologia , Corpo Clínico , Modelos Psicológicos , Psicoterapia , Feminino , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
8.
BMJ ; 374: n1647, 2021 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-34289996

RESUMO

OBJECTIVE: To evaluate effects of remote monitoring of adjuvant chemotherapy related side effects via the Advanced Symptom Management System (ASyMS) on symptom burden, quality of life, supportive care needs, anxiety, self-efficacy, and work limitations. DESIGN: Multicentre, repeated measures, parallel group, evaluator masked, stratified randomised controlled trial. SETTING: Twelve cancer centres in Austria, Greece, Norway, Republic of Ireland, and UK. PARTICIPANTS: 829 patients with non-metastatic breast cancer, colorectal cancer, Hodgkin's disease, or non-Hodgkin's lymphoma receiving first line adjuvant chemotherapy or chemotherapy for the first time in five years. INTERVENTION: Patients were randomised to ASyMS (intervention; n=415) or standard care (control; n=414) over six cycles of chemotherapy. MAIN OUTCOME MEASURES: The primary outcome was symptom burden (Memorial Symptom Assessment Scale; MSAS). Secondary outcomes were health related quality of life (Functional Assessment of Cancer Therapy-General; FACT-G), Supportive Care Needs Survey Short-Form (SCNS-SF34), State-Trait Anxiety Inventory-Revised (STAI-R), Communication and Attitudinal Self-Efficacy scale for cancer (CASE-Cancer), and work limitations questionnaire (WLQ). RESULTS: For the intervention group, symptom burden remained at pre-chemotherapy treatment levels, whereas controls reported an increase from cycle 1 onwards (least squares absolute mean difference -0.15, 95% confidence interval -0.19 to -0.12; P<0.001; Cohen's D effect size=0.5). Analysis of MSAS sub-domains indicated significant reductions in favour of ASyMS for global distress index (-0.21, -0.27 to -0.16; P<0.001), psychological symptoms (-0.16, -0.23 to -0.10; P<0.001), and physical symptoms (-0.21, -0.26 to -0.17; P<0.001). FACT-G scores were higher in the intervention group across all cycles (mean difference 4.06, 95% confidence interval 2.65 to 5.46; P<0.001), whereas mean scores for STAI-R trait (-1.15, -1.90 to -0.41; P=0.003) and STAI-R state anxiety (-1.13, -2.06 to -0.20; P=0.02) were lower. CASE-Cancer scores were higher in the intervention group (mean difference 0.81, 0.19 to 1.43; P=0.01), and most SCNS-SF34 domains were lower, including sexuality needs (-1.56, -3.11 to -0.01; P<0.05), patient care and support needs (-1.74, -3.31 to -0.16; P=0.03), and physical and daily living needs (-2.8, -5.0 to -0.6; P=0.01). Other SCNS-SF34 domains and WLQ were not significantly different. Safety of ASyMS was satisfactory. Neutropenic events were higher in the intervention group. CONCLUSIONS: Significant reduction in symptom burden supports the use of ASyMS for remote symptom monitoring in cancer care. A "medium" Cohen's effect size of 0.5 showed a sizable, positive clinical effect of ASyMS on patients' symptom experiences. Remote monitoring systems will be vital for future services, particularly with blended models of care delivery arising from the covid-19 pandemic. TRIAL REGISTRATION: Clinicaltrials.gov NCT02356081.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Telefone Celular , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/diagnóstico , Qualidade de Vida , Telemedicina/métodos , Adulto , Idoso , Áustria , Neoplasias da Mama/psicologia , Neoplasias da Mama/terapia , Quimioterapia Adjuvante/efeitos adversos , Neoplasias Colorretais/psicologia , Neoplasias Colorretais/terapia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/psicologia , Feminino , Grécia , Doença de Hodgkin/psicologia , Doença de Hodgkin/terapia , Humanos , Irlanda , Linfoma não Hodgkin/psicologia , Linfoma não Hodgkin/terapia , Masculino , Pessoa de Meia-Idade , Noruega , Telemedicina/instrumentação , Resultado do Tratamento , Reino Unido
9.
J Biol Rhythms ; 36(1): 71-83, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33480295

RESUMO

Cancer-related fatigue has been related to circadian disruptions and lower levels of sleep quality. However, it is unknown whether the circadian phase, which is associated with chronotype and timing of sleep, is related to fatigue after cancer. The aims of this study were to investigate the associations between (1) chronotype and cancer-related fatigue and (2) sleep quality and cancer-related fatigue. In this cross-sectional questionnaire study, 458 (non-)Hodgkin lymphoma survivors (n = 231 female, mean age 49.7 years) completed a Visual Analogue Scale for fatigue (VAS-fatigue) from 0 (no fatigue) to 10 (worst imaginable fatigue), the Munich Chronotype Questionnaire (MCTQ), and the Pittsburgh Sleep Quality Index (PSQI) between October 2018 and July 2019. A hierarchical linear regression analysis was used to evaluate the associations between the dependent variable fatigue and chronotype (based on early, intermediate, or late average midsleep) in Model 1, and fatigue and sleep quality in Model 2. The results showed no indications for an association between chronotype and fatigue (all p values ≥ 0.50). There were associations between two (out of seven) aspects of sleep quality and fatigue: subjective sleep quality (p < 0.001) and daily dysfunctioning (p < 0.001). Therefore, it is more likely that fatigue is associated with self-reported sleep quality rather than with chronotype. However, experimental studies with objective, physiological data on circadian phase and sleep quality are necessary to confirm the conclusions of this cross-sectional study.


Assuntos
Sobreviventes de Câncer/psicologia , Ritmo Circadiano , Fadiga , Linfoma não Hodgkin/fisiopatologia , Linfoma não Hodgkin/psicologia , Sono , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
10.
J Neurooncol ; 149(1): 171-179, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32737735

RESUMO

PURPOSE: Although primary central nervous system lymphomas (PCNSL) represent extremely aggressive brain tumours, high-dose methotrexate in combination with other chemotherapeutic agents has resulted in long-term disease control in a substantial fraction of patients. Advances in treatment efficacy with longer survival resulted in a focus on additional outcome measures such as quality of life (QoL) and neurocognition. Despite recent evidence of return to work as an important aspect of patients' QoL, little is known about occupational reintegration in PCNSL long-term survivors. This study aimed to detect specific characteristics of patients who successfully resumed work after complete response to therapy. METHODS: Patients with ongoing complete response to therapy completed a test battery capturing neurocognition, social integration, QoL and psychological burden. Of 25 patients who had been in regular employment before diagnosis only eight returned to work after treatment (32%). RESULTS: Patients who resumed work rated important aspects of their QoL and social integration as higher and suffered less from symptoms affecting QoL than patients who did not resume work. Also, the subjective confidence in their ability to work was higher in patients who resumed work, but independent predictors of return to work were not found in logistic regression analyses. CONCLUSION: Occupational (re)integration is of clinical relevance in PCNSL patients after complete response to therapy. Due to the small size of our cohort the present results should be considered an exploratory first step. Return to work might be a crucial aspect of QoL and (re)integration into society after cure of PCNSL.


Assuntos
Sobreviventes de Câncer/psicologia , Neoplasias do Sistema Nervoso Central/psicologia , Cognição/fisiologia , Linfoma não Hodgkin/psicologia , Qualidade de Vida , Retorno ao Trabalho/psicologia , Retorno ao Trabalho/estatística & dados numéricos , Adulto , Idoso , Neoplasias do Sistema Nervoso Central/terapia , Terapia Combinada , Feminino , Seguimentos , Humanos , Linfoma não Hodgkin/terapia , Masculino , Pessoa de Meia-Idade , Prognóstico
11.
Acta Oncol ; 59(8): 959-966, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32412348

RESUMO

Objectives: The common sense model provides a theoretical framework for understanding substantial fatigue among (haematological) cancer survivors based on their illness perceptions. We therefore examined the associations between modifiable illness perceptions and substantial fatigue while controlling for sociodemographic, clinical, and psychological factors (symptoms of depression and anxiety) among haematological cancer survivors.Methods: Data from the population-based PROFILES registry were used. Survivors diagnosed between 1999 and 2013 with Hodgkin lymphoma (N = 164), non-Hodgkin lymphoma (N = 655) and chronic lymphocytic leukaemia (N = 174) were included. Survivors completed the Brief Illness Perception Questionnaire (B-IPQ), the Fatigue Assessment Scale (FAS), and Hospital Anxiety and Depression Scale (HADS). Multivariable logistic regressions analyses were performed for the total group and three haematological cancers separately relating illness perceptions to substantial fatigue (>21 FAS).Results: Haematological cancer survivors with illness perceptions that represent more negative consequences (consequences, OR = 1.27; 95%CI = 1.13-1.42); attribute more symptoms to their illness (identity, OR = 1.29; 95%CI = 1.17-1.43); and have a poorer illness understanding (coherence, 1.13; 1.04-1.22) were more often substantially fatigued. For the remaining five illness perceptions, no significant association was found. Non-Hodgkin lymphoma survivors who reported a poor illness understanding (coherence, OR = 1.35; 95% CI = 1.06-1.72) and chronic lymphocytic leukaemia survivors who reported that treatment can control (OR = 1.25; 95%CI = 1.01-1.55) the illness experienced more often substantial fatigue.Conclusion: Those who experience more consequences of their disease, attribute more symptoms to their illness, and have a poorer illness understanding, have a higher risk to experience substantial levels of fatigue even years after diagnosis. Psychological interventions changing these illness perceptions may be beneficial in reducing fatigue among haematological cancer survivors.


Assuntos
Sobreviventes de Câncer/psicologia , Fadiga/psicologia , Neoplasias Hematológicas/psicologia , Negativismo , Adulto , Ansiedade/psicologia , Depressão/psicologia , Fadiga/etiologia , Feminino , Doença de Hodgkin/psicologia , Humanos , Leucemia Linfocítica Crônica de Células B/psicologia , Modelos Logísticos , Linfoma não Hodgkin/psicologia , Masculino , Pessoa de Meia-Idade , Percepção , Avaliação de Sintomas
12.
J Geriatr Oncol ; 11(5): 790-795, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32008957

RESUMO

OBJECTIVES: To compare cognition in a group of older long-term survivors from Non-Hodgkin Lymphoma (NHL) and in a corresponding group of non-cancer controls of the same age. Functional status, polypharmacy and multimorbidity were also evaluated. METHODS: A cross-sectional study was performed in a population of 63 outpatient long-term survivors from NHL, aged 65 or more and 61 non-cancer controls. Socio-demographic, clinical and functional data were collected. Cognitive function was assessed through neuropsychological tests. RESULTS: NHL survivors showed a slightly worse functional status than controls, they were affected by more chronic conditions (3.4 vs 2.3; p = .003) and were taking a higher number of medications (3.4 vs 2.3; p = .03). The Mini Mental State Examination (MMSE) was not significantly different between the groups. NHL survivors performed worse than controls in executive functioning (Trail Making Test B-A 47.9 vs 32.1 p = .04, OR for Stroop test time over 75th percentile in survivors: 2.66; CI 95% 1.04-6.61; OR for Multiple Features Target Cancellation time over 75th percentile in survivors: 2.84; CI 95% 1.10-7.31). A small, statistically significant difference was also observed in verbal memory scores between the two groups. . CONCLUSIONS: The findings of this study suggest that, compared with non-cancer controls, older survivors from NHL may have a lower cognitive performance, especially in the executive functioning and attention domains, regardless of multimorbidity and polypharmacy. Further evidence from larger samples is needed to confirm such findings and better characterize cognitive decline in NHL survivors.


Assuntos
Disfunção Cognitiva , Linfoma não Hodgkin , Fatores Etários , Idoso , Cognição , Disfunção Cognitiva/psicologia , Estudos Transversais , Humanos , Linfoma não Hodgkin/psicologia , Testes Neuropsicológicos , Sobreviventes
13.
Biol Blood Marrow Transplant ; 26(1): 34-43, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31605820

RESUMO

CD19-targeted chimeric antigen receptor (CAR) modified T cell immunotherapy is a novel treatment with promising results in patients with relapsed/refractory lymphoid malignancies. CAR T cell therapy has known early toxicities of cytokine release syndrome and neurotoxicity, but little is known about long-term neuropsychiatric adverse effects. We have used patient-reported outcomes, including Patient-Reported Outcomes Measurement Information System (PROMIS) measures, to assess neuropsychiatric and other patient-reported outcomes of 40 patients with relapse/refractory chronic lymphocytic leukemia, non-Hodgkin lymphoma, and acute lymphoblastic leukemia 1 to 5 years after treatment with CD19-targeted CAR T cells. Mean T scores of PROMIS domains of global mental health, global physical health, social function, anxiety, depression, fatigue, pain, and sleep disturbance were not clinically meaningfully different from the mean in the general US population. However, 19 patients (47.5%) reported at least 1 cognitive difficulty and/or clinically meaningful depression and/or anxiety, and 7 patients (17.5%) scored ≤40 in global mental health, indicating at least 1 standard deviation worse than the general population mean. Younger age was associated with worse long-term global mental health (P = .02), anxiety (P = .001), and depression (P= .01). Anxiety before CAR T cell therapy was associated with increased likelihood of anxiety after CAR T cell therapy (P = .001). Fifteen patients (37.5%) reported cognitive difficulties after CAR T cell therapy. Depression before CAR T cell therapy was statistically significantly associated with higher likelihood of self-reported post-CAR T cognitive difficulties (P = .02), and there was a trend for an association between acute neurotoxicity and self-reported post-CAR T cognitive difficulties (P = .08). Having more post-CAR T cognitive difficulties was associated with worse global mental health and global physical health. Our study demonstrates overall good neuropsychiatric outcomes in 40 long-term survivors after CAR T cell therapy. However, nearly 50% of patients in the cohort reported at least 1 clinically meaningful negative neuropsychiatric outcome (anxiety, depression, or cognitive difficulty), indicating that a significant number of patients would likely benefit from mental health services following CAR T cell therapy. Younger age, pre-CAR T anxiety or depression, and acute neurotoxicity may be risk factors for long-term neuropsychiatric problems in this patient population. Larger studies are needed to confirm these findings.


Assuntos
Transferência Adotiva/efeitos adversos , Leucemia Linfocítica Crônica de Células B/terapia , Linfoma não Hodgkin/terapia , Transtornos Neurocognitivos , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Receptores de Antígenos Quiméricos/administração & dosagem , Autorrelato , Adulto , Idoso , Feminino , Seguimentos , Humanos , Leucemia Linfocítica Crônica de Células B/epidemiologia , Leucemia Linfocítica Crônica de Células B/psicologia , Linfoma não Hodgkin/epidemiologia , Linfoma não Hodgkin/psicologia , Masculino , Pessoa de Meia-Idade , Transtornos Neurocognitivos/epidemiologia , Transtornos Neurocognitivos/etiologia , Transtornos Neurocognitivos/psicologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/psicologia
14.
Psychooncology ; 29(2): 364-372, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31654534

RESUMO

OBJECTIVE: This study aimed to evaluate fear of cancer recurrence (FCR) among lymphoma patients who completed treatment and its impact on survival and quality of life (QOL). METHODS: In this prospective cohort study, 467 lymphoma patients were included who completed treatment with curative intent between February 2012 and March 2017. FCR was measured using a question from the Korean version of the QOL in Cancer Survivors Questionnaire. QOL and general health and functioning were measured using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30. Participants were actively followed up for all-cause and disease-specific mortality. RESULTS: In total, 16.3% of the patients had severe FCR. The adjusted hazard ratio (HR) for all-cause mortality comparing participants with and without severe FCR was 2.52 (95% CI = 1.15-5.54), and the association was stronger in indolent non-Hodgkin lymphoma (NHL) (HR = 6.77; 95% CI = 1.04-43.92). Participants with severe FCR were also at higher risk of lymphoma-specific mortality (HR = 2.62; 95% CI = 1.13-6.05) than patients without severe FCR. Patients with severe FCR had significantly worse general health status (64.3 vs 71.0, P = .03) and physical (82.4 vs 76.7, P < .01), emotional (68.5 vs 84.8, P < .001), and social functioning (67.8 vs 84.2, P < .001) than patients without severe FCR. CONCLUSIONS: A substantial number of participants with lymphoma experience FCR after treatment completion, even in the case of indolent lymphomas. Given the negative impact of severe FCR on survival and general health and functional status, active monitoring and appropriate management of FCR should be considered in clinical settings.


Assuntos
Sobreviventes de Câncer/psicologia , Medo/psicologia , Linfoma/psicologia , Recidiva Local de Neoplasia/psicologia , Qualidade de Vida/psicologia , Adulto , Idoso , Feminino , Humanos , Linfoma/prevenção & controle , Linfoma não Hodgkin/psicologia , Masculino , Pessoa de Meia-Idade , Transtornos Fóbicos , Estudos Prospectivos , Inquéritos e Questionários
15.
BMC Cancer ; 19(1): 1178, 2019 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-31795958

RESUMO

BACKGROUND: Previous studies have suggested that lymphoma survivors commonly display altered Health-Related Quality of Life (HRQoL). Because these were predominantly cross-sectional studies, the dynamic of events as well as the factors which influence HRQoL remain to be determined. METHODS: We conducted a prospective study on a cohort of 204 Hodgkin and non-Hodgkin lymphoma survivors who remained disease-free 2 years after undergoing chemotherapy (referred to the M0-M12-M24 periods). RESULTS: We found that although Physical and Mental Component Scores (PCS and MCS) of HRQoL significantly improved from M0 to M24 in the vast majority of patients (favorable group), approximately 20% of patients displayed severe alterations in HRQoL (global SF-36 scores < 50) extending over the 2-year period (unfavorable group). Low M24 PCSs were associated with Post-Traumatic Stress Disorder (PTSD), depression, cardiovascular events and neuropathy. In contrast social determinants, comorbidity and infections, as well as several other parameters related to the disease or to the treatment itself were not associated with low M24 PCSs. Low M24 MCSs were associated with a low educational level, aggressive histology, infections, cardiovascular events and PTSS. However, the most predictive risk factor for low SF-36 scores at M24 was a low SF-36 score at M12. The unfavorable group also displayed a low incidence of return to work. CONCLUSIONS: Although the HRQoL of lymphoma survivors generally improved over time, persistent and severe HRQoL alterations still affected approximately one fifth of patients, resulting in important social consequences. This specific group, which presents with identifiable risk factors, may benefit from early, targeted psycho-social support.


Assuntos
Sobreviventes de Câncer/psicologia , Doença de Hodgkin/psicologia , Linfoma não Hodgkin/psicologia , Qualidade de Vida/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Adulto Jovem
17.
Health Qual Life Outcomes ; 17(1): 115, 2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31266501

RESUMO

BACKGROUND: Long-term lymphoma survivors often complain of persistent fatigue that remains unexplained. While largely reported in Hodgkin lymphoma (HL), long-term fatigue is poorly documented in non-Hodgkin lymphomas (NHL). Data collected in two cohort studies were used to illustrate the fatigue level changes with time in the two populations. METHODS: Two cross-sectional studies were conducted in 2009-2010 (HL) and in 2015 (NHL) in survivors enrolled in European Organisation for Research and Treatment of Cancer (EORTC) Lymphoma Group and Lymphoma Study Association (LYSA) trials. The same protocol and questionnaires were used in both studies including the Multidimensional Fatigue Inventory (MFI) tool to assess fatigue and a checklist of health disorders. Multivariate linear regression models were used in the two populations separately to assess the influence of time since diagnosis and primary treatment, age, gender, education level, cohabitation status, obesity and health disorders on fatigue level changes. Fatigue level changes were compared to general population data. RESULTS: Overall, data of 2023 HL and 1619 NHL survivors with fatigue assessment available (99 and 97% of cases, respectively) were analyzed. Crude levels of fatigue were similar in the two populations. Individuals who reported health disorders (61% of HL and 64% of NHL) displayed higher levels of fatigue than those who did not (P <  0.001). HL survivors showed increasing fatigue level with age while in NHL survivors mean fatigue level remained constant until age 70 and increased beyond. HL survivors showed fatigue changes with age higher than those of the general population with health disorders while NHL survivors were in between those of the general population with and without health disorders. CONCLUSIONS: Among lymphoma survivors progressive increase of fatigue level with time since treatment completion is a distinctive feature of HL. Our data suggest that changes in fatigue level are unlikely to only depend on treatment complications and health disorders. Investigations should be undertaken to identify which factors including biologic mechanisms could explain why a substantial proportion of survivors develop high level of fatigue.


Assuntos
Sobreviventes de Câncer , Fadiga/etiologia , Doença de Hodgkin/complicações , Linfoma não Hodgkin/complicações , Qualidade de Vida , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Doença de Hodgkin/psicologia , Humanos , Modelos Lineares , Linfoma não Hodgkin/psicologia , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
18.
Psychol Health Med ; 24(7): 781-787, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30714815

RESUMO

The aim of this study was to measure the prevalence of FCR among a sample of French lymphoma survivors and to determine factors associated with clinical levels of FCR. The study was conducted with two cross-sectional measures: sociodemographic and anxiety, depression as well as health-related quality of life (HRQoL) scores were measured at the baseline of the post-cancer period and FCR was evaluated during the first 3 years of survivorship. The prevalence of clinical levels of FCR (≥13) was evaluated by the Fear of Cancer Recurrence Inventory - Short Form (FCRI-SF) among non- and Hodgkin lymphoma survivors undergoing prior first-line chemotherapy. Among 108 lymphoma survivors with an average follow-up of 1.6 years (range 0.3-3.0 years), clinical levels of FCR (≥13) were observed for 44.4% (n = 48). Multivariate analysis indicated that baseline anxiety and low quality of life were related to clinically significant FCR levels.


Assuntos
Ansiedade/psicologia , Sobreviventes de Câncer/psicologia , Depressão/psicologia , Medo , Doença de Hodgkin/psicologia , Linfoma não Hodgkin/psicologia , Recidiva Local de Neoplasia/psicologia , Adulto , Idoso , Estudos Transversais , Feminino , Seguimentos , França , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida/psicologia , Papel do Doente , Inquéritos e Questionários
19.
Eur J Cancer Care (Engl) ; 28(1): e12951, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30284333

RESUMO

Many people with haematological cancers will not meet the diagnostic criteria for a psychological disorder, but will still suffer distress during treatment and beyond. The current study aimed to explore the nature and timing of psychosocial distress experienced by haematological cancer survivors. Twenty-three post-treatment haematological cancer survivors participated in a semi-structured interview. Data were analysed using thematic analysis which involved identifying, analysing and reporting themes. Four themes were identified: Apprehension about leaving the safety of the health care system comprises the struggles encountered when transitioning from patient to survivor, Uncertainty and life transitions in the post-treatment period encompasses the changes survivors face when attempting to re-enter their "normal" lives, Distress associated with ongoing physical problems or impairment describes issues associated with the ongoing physical sequelae, and Fear of recurrence encapsulates how the continuing threat of cancer recurrence impacted survivors. This study has found that distress is ongoing for many haematological cancer survivors in the post-treatment period. It is imperative that distress is identified and support offered to those in need to prevent further psychosocial issues. It is especially important to consider the psychosocial needs of survivors in the post-treatment stage who are discharged from the health system may be unsure where to seek help.


Assuntos
Ansiedade/psicologia , Sobreviventes de Câncer/psicologia , Depressão/psicologia , Neoplasias Hematológicas/psicologia , Estresse Psicológico/psicologia , Adulto , Idoso , Feminino , Doença de Hodgkin/psicologia , Humanos , Leucemia Mieloide Aguda/psicologia , Linfoma não Hodgkin/psicologia , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/psicologia , Fatores de Tempo
20.
J Adv Nurs ; 74(11): 2622-2629, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29989199

RESUMO

AIM: The aim of this study was to explore the use of metaphors by non-Hodgkin's lymphoma (NHL) patients undergoing chemotherapy in a haematology ward setting. BACKGROUND: There is a dearth of literature exploring the use of metaphors in people with cancer undergoing aggressive treatment. Hence, this study aims to explore the use of metaphors in NHL patients undergoing chemotherapy and additionally, examining whether the use of such metaphors has an empowering/disempowering effect. DESIGN: A qualitative design was used. METHODS: The participants were six adult patients diagnosed with NHL and undergoing chemotherapy. Data collection was undertaken between July 2016-December 2016. Each participant was interviewed twice using semi-structured interviews. The data were analysed using Pragglejaz method for finding metaphors. FINDINGS: The participants used metaphors 17 times per 1,000 words to describe their experience of undergoing chemotherapy for NHL. The metaphors cited focused on aspects relating to "war", "prison" and a "journey". CONCLUSIONS: The findings demonstrate that certain metaphors used by the study participants, such as those pertaining to "war" or a "journey", concur with those described in narratives of people with cancer in general. However, the use of the "prison" metaphor by NHL patients undergoing chemotherapy relates particularly to their context of being isolated while undergoing treatment for fear of infection. Consequently, there is the need to interpret metaphors in relation to the specific type of illness and context. Furthermore, the findings of this study suggest that the impact of metaphors in empowering/disempowering people with cancer depends on the unique interpretation of the individual patient.


Assuntos
Adaptação Psicológica , Antineoplásicos/uso terapêutico , Linfoma não Hodgkin/tratamento farmacológico , Linfoma não Hodgkin/psicologia , Metáfora , Pacientes/psicologia , Estresse Psicológico , Adulto , Idoso , Atitude Frente a Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA