Impact of Ageing on the Survivorship Experiences of Patients with Hodgkin Lymphoma
Authors: O. Bamigbola¹, C. Bates¹, and L. Warwick²
¹ Lymphoma Coalition, Research, Mississauga, ON, Canada
² Lymphoma Coalition, Management, Mississauga, ON, Canada
Introduction
- Hodgkin lymphoma (HL) often affects young adults and has one of the highest cure rates among all cancers, leading to an increasing number of survivors each year.
- Its treatment may cause long-term or late effects, which can impact a patient’s overall health and quality of life. These effects raise concerns about survivorship care and long-term management.
- This study uses data from the Lymphoma Coalition (LC) 2022 Global Patient Survey (GPS) on lymphoma and CLL to examine the survivorship experiences of HL patients in remission.
Methods
Study Design
- Sub-analysis of the LC 2022 GPS, an online global survey of patients with lymphoma and CLL.
- Conducted every two years.
- Hosted by a third-party from February–April 2022, in 19 languages.
Respondents
- Total respondents (global): 8,637 from 70+ countries.
- HL respondents: 713 patients, 124 caregivers.
- Subgroup analyzed: 581 HL patients who had HL, 447 of whom were in remission.
- Patients in remission were grouped into:
- Younger group: 18–39 years (n=248)
- Older group: 40+ years (n=199)
Statistical Analysis
- Demographics of both groups examined.
- Univariate and bivariate analyses of questions relating to survivorship support.
- Performed using IBM SPSS v27.
Results
Psychosocial Issues
- Patients reported psychosocial issues experienced in the last 12 months because of HL and treatment.
- Older patients (40+) reported the lowest prevalence (39%).
- Younger patients (18–39) reported higher prevalence (63%), with psychosocial issues being the most common.
- Significant differences observed in prevalence of issues such as depression, anxiety, and fear of relapse (see Table 1).
Side Effects and Impact on Daily Life
- Patients reported long-term and late side effects affecting:
- Everyday life
- Employment
- Relationships
- Younger patients reported significantly higher impacts in most categories compared to older patients (Table 1).
Survivorship Support
- Only a small proportion in both age groups felt supported in survivorship, unlike during active care.
- Main issues:
- Limited knowledge of post-treatment care plans
- Lack of follow-up visits
- Younger survivors felt disproportionately unsupported.
Table 1. Survivorship Experiences of Patients with Hodgkin Lymphoma
| Category | 18–39 yrs (n=248) | 40+ yrs (n=199) | Χ² (p-value) |
|---|---|---|---|
| Psychosocial issues experienced in last 12 months | 62.9% | 39.3% | 20.30 (0.001) |
| Depression | 29.8% | 14.6% | 19.58 (0.002) |
| Anxiety | 34.3% | 16.1% | 21.44 (<0.001) |
| Fear of relapse | 31.5% | 18.1% | 12.00 (0.003) |
| Impact of HL and side effects on daily life | |||
| Everyday life | 48.8% | 31.7% | 11.07 (0.001) |
| Employment | 30.6% | 23.6% | 4.7 (0.032) |
| Relationships | 13.7% | 12.6% | 1.35 (0.85) |
| Felt supported in survivorship (vs. active care) | 27.4% | 24.6% | 3.27 (0.515) |
Key Insights
- Younger survivors with HL are disproportionately affected by psychosocial issues.
- They are more impacted by symptoms and side effects than older survivors.
- Both age groups report less survivorship support compared to when receiving active treatment.
Conclusion
- Compared to older survivors, younger survivors with HL are more disproportionately affected by psychosocial issues and side effects.
- This group requires additional attention and support.
- Addressing psychosocial impacts should be a key part of survivorship care for HL patients.
- Healthcare providers must ensure younger survivors receive adequate guidance and follow-up.
Conflict of Interest, Disclosures, and Contact Information
- Funding support: Pfizer Inc., Novartis Corporation, Takeda Oncology.
- Disclaimer: None of the authors has a conflict of interest.
For further details on the LC 2022 GPS:
- Scan the QR code in the original document.
- Contact Lymphoma Coalition:
- Email: bambigbola@lymphomacoalition.org
- Email: cbates@lymphomacoalition.org
Summary
Hodgkin lymphoma (HL) has high cure rates, leading to many long-term survivors. However, treatment can cause ongoing health and psychosocial issues.
A sub-analysis of the Lymphoma Coalition 2022 Global Patient Survey compared survivorship experiences of HL patients in remission, divided into two groups: younger survivors (18–39 years, n=248) and older survivors (40+ years, n=199).
Key Findings
- Psychosocial issues were significantly more common among younger survivors (63%) than older survivors (39%).
- Younger survivors reported higher levels of depression, anxiety, and fear of relapse.
- Both groups experienced long-term side effects, but younger survivors reported a greater impact on everyday life and employment.
- Only a minority in either age group felt adequately supported during survivorship, compared to when receiving active treatment.
Conclusion
Younger survivors of HL are disproportionately affected by psychosocial and quality-of-life challenges. Survivorship care should place stronger emphasis on addressing psychosocial needs, follow-up care, and post-treatment planning, particularly for younger patients.