Longitudinal Patient-Reported Outcomes in Older Adults With Aggressive Lymphomas Receiving Chemoimmunotherapy.

Area of Science:

• Geriatric Oncology
• Hematology
• Patient-Reported Outcomes

Background:

• Aggressive non-Hodgkin lymphoma (aNHL) predominantly affects older adults.
• Chemoimmunotherapy offers durable remissions but carries significant toxicities.
• Limited longitudinal data exists on patient-reported outcomes (PROs) in older adults with aNHL undergoing chemoimmunotherapy.

Purpose of the Study:

• To longitudinally assess patient-reported outcomes (PROs) in older adults receiving chemoimmunotherapy for aNHL.
• To evaluate the impact of age and frailty on quality of life (QoL) and symptom burden over time.
• To identify factors associated with QoL at one year post-treatment initiation.

Main Methods:

• A longitudinal study of 105 adults aged ≥65 years with aNHL receiving chemoimmunotherapy.
• Quality of life (QoL), physical symptoms, anxiety, and depression were assessed using validated questionnaires (FACT-Lym, ESAS-r, HADS).
• Frailty was assessed at baseline using Geriatric Assessment (GA) and Vulnerable Elders Survey-13 (VES-13); longitudinal data analyzed using mixed-effects models.

Main Results:

• Significant improvements in QoL, physical symptoms, anxiety, and depression were observed over 1 year (P≤.001).
• QoL improvements were consistent across age categories (65-74 vs. ≥75 years) and frailty statuses.
• Frailty (GA) was associated with worse QoL at 1 year (β=-9.90; P=.036), while being married/partnered was associated with better QoL (β=11.6; P=.026).

Conclusions:

• Older adults with aNHL demonstrate significant and sustained improvements in QoL and symptom burden with chemoimmunotherapy up to one year post-initiation.
• Frailty status is a significant predictor of poorer QoL at one year, underscoring its clinical relevance.
• Integrating geriatric assessments into treatment planning is crucial for optimizing care for older adults with aNHL.