TY - JOUR
T1 - The course of self-perceived cognitive functioning among patients with lymphoma and the co-occurrence with fatigue and psychological distress
AU - Ekels, Afke
AU - Oerlemans, Simone
AU - Schagen, Sanne B
AU - Issa, Djamila E
AU - Thielen, Noortje
AU - Nijziel, Marten R
AU - van der Poel, Marjolein W M
AU - Arts, Lindy P J
AU - Posthuma, Eduardus F M
AU - van de Poll-Franse, Lonneke V
PY - 2023/9/27
Y1 - 2023/9/27
N2 - PURPOSE: To investigate the proportion of patients with lymphoma with persistent clinically relevant cognitive impairment, and its relation to treatment, fatigue, and psychological distress. METHODS: Patients with diffuse-large-B-cell-lymphoma (DLBCL), follicular-lymphoma (FL), and chronic-lymphocytic-leukemia (CLL)/small-lymphocytic-lymphoma (SLL), diagnosed between 2004-2010 or 2015-2019, were followed up to 8 years post-diagnosis. Sociodemographic and clinical data were obtained from the Netherlands Cancer Registry and the Population-based HAematological Registry for Observational Studies. The EORTC QLQ-C30 was used to assess cognitive functioning and fatigue, and the HADS to assess psychological distress. Individual growth curve models were performed. Results were compared with an age- and sex-matched normative population. RESULTS: A total of 924 patients were included (70% response rate). Persistent cognitive impairment was twice as high in patients (30%) compared to the normative population (15%). Additionally, 74% of patients reported co-occurring symptoms of persistent fatigue and/or psychological distress. Patients with FL (-?23 points, p?<?0.001) and CLL/SLL (-?10 points, p?<?0.05) reported clinically relevant deterioration of cognitive functioning, as did the normative population (FLnorm?-?5 points, DLBCLnorm?-?4 points, both p?<?0.05). Younger age, higher fatigue, and/or psychological distress at inclusion were associated with worse cognitive functioning (all p's?<?0.01). Treatment appeared less relevant. CONCLUSION: Almost one-third of patients with lymphoma report persistent cognitive impairment, remaining present up to 8 years post-diagnosis. Early onset and co-occurrence of symptoms highlight the need for clinicians to discuss symptoms with patients early. IMPLICATIONS FOR CANCER SURVIVORS: Early recognition of cognitive impairment could increase timely referral to suitable supportive care (i.e., lifestyle interventions) and reduce (long-term) symptom burden.
AB - PURPOSE: To investigate the proportion of patients with lymphoma with persistent clinically relevant cognitive impairment, and its relation to treatment, fatigue, and psychological distress. METHODS: Patients with diffuse-large-B-cell-lymphoma (DLBCL), follicular-lymphoma (FL), and chronic-lymphocytic-leukemia (CLL)/small-lymphocytic-lymphoma (SLL), diagnosed between 2004-2010 or 2015-2019, were followed up to 8 years post-diagnosis. Sociodemographic and clinical data were obtained from the Netherlands Cancer Registry and the Population-based HAematological Registry for Observational Studies. The EORTC QLQ-C30 was used to assess cognitive functioning and fatigue, and the HADS to assess psychological distress. Individual growth curve models were performed. Results were compared with an age- and sex-matched normative population. RESULTS: A total of 924 patients were included (70% response rate). Persistent cognitive impairment was twice as high in patients (30%) compared to the normative population (15%). Additionally, 74% of patients reported co-occurring symptoms of persistent fatigue and/or psychological distress. Patients with FL (-?23 points, p?<?0.001) and CLL/SLL (-?10 points, p?<?0.05) reported clinically relevant deterioration of cognitive functioning, as did the normative population (FLnorm?-?5 points, DLBCLnorm?-?4 points, both p?<?0.05). Younger age, higher fatigue, and/or psychological distress at inclusion were associated with worse cognitive functioning (all p's?<?0.01). Treatment appeared less relevant. CONCLUSION: Almost one-third of patients with lymphoma report persistent cognitive impairment, remaining present up to 8 years post-diagnosis. Early onset and co-occurrence of symptoms highlight the need for clinicians to discuss symptoms with patients early. IMPLICATIONS FOR CANCER SURVIVORS: Early recognition of cognitive impairment could increase timely referral to suitable supportive care (i.e., lifestyle interventions) and reduce (long-term) symptom burden.
KW - Cognition
KW - Lymphoma
KW - Patient-reported outcome
KW - Population-based registry
KW - Quality of life
U2 - 10.1007/s11764-023-01458-2
DO - 10.1007/s11764-023-01458-2
M3 - Article
SN - 1932-2259
JO - Journal of Cancer Survivorship-Research and Practice
JF - Journal of Cancer Survivorship-Research and Practice
ER -