Abstract 1865P
Background
In treatment of Hodgkin´s lymphoma (HL), chemotherapy-induced peripheral neuropathy (CIPN) is a dose limiting side effect, which can influence both life expectancy and quality of life (QoL). We aimed to describe occurrence of CIPN associated symptoms in long term HL survivors compared to controls.
Methods
In a national multicenter study, 303 survivors (52% male, median age at survey 45 years, median time from treatment 16 years) treated between 1997- 2006 completed a questionnaire, including EORTC QLQ-CIPN 20 (for CIPN associated symptoms) and SF-36 (for QoL). Results are presented as total neuropathy score (TNS) or sub scores of motor-, sensory- and autonomic neuropathy and in men, erectile dysfunction (ED; scores transformed to a 0-100 scale, higher scores imply more symptoms) and compared to an age and sex matched Dutch normative population (n=606). Clinical data were extracted from medical files and factors associated with CIPN analyzed by linear regression analysis. Effect sizes are expressed as Hedges´ g.
Results
Mean TNS (standard deviation; SD) was 12.8 (13.8) and 2.3 (5.0) in survivors and controls respectively (p < 0.001), with Hedges’ g 1.17 (large effect). All sub scores were significantly higher in survivors compared to controls (p < 0.001). Mean number of comorbidities was higher in survivors (1.6; SD 1.4) than controls (0.6; SD 1.0; p < 0.001), but in multivariate analysis this difference did not fully account for higher TNS in survivors. In multivariate analysis of HL survivors alone, number of reported comorbidities (p < 0.001) and female sex (p = 0.046) were significantly associated with higher TNS. With 94 % of survivors having received at least one cycle of neurotoxic chemotherapy, no significant effects of disease or treatment related parameters were found. Reduced physical and mental QoL was seen with higher TNS (p < 0.001).
Conclusions
Compared to the normal population, HL survivors report a higher burden of CIPN associated symptoms. Female sex and number of comorbidities, but not type or intensity of treatment, were associated with symptom burden. CIPN associated symptoms negatively affect QoL. Long term CIPN associated symptoms in HL survivors may be related to factors other than use of neurotoxic chemotherapy.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Stiftelsen Dam.
Disclosure
U-M. Fagerli: Advisory/Consultancy: Takeda; Advisory/Consultancy: Roche. All other authors have declared no conflicts of interest.