Long-Term Quality of Life in 1777 Persons With Hodgkin Lymphoma and 6166 Matched Comparators

Survival has improved substantially for patients with Hodgkin lymphoma (HL), but long-term quality of life (QoL) remains incompletely understood. This was a Danish, nationwide, cross-sectional study of QoL among persons with a diagnosis of HL matched 1:10 to general population comparators. Questionnaires included the HeartQoL, the European Organization for Research and Treatment of Cancer Quality of Life Core-30 (QLQ-C30), the Short Form-36 (SF-36), and the EuroQoL Health Questionnaire (EQ-5D). Mean differences (MD) were estimated using linear regression adjusted for sex and age, and stratified by time since diagnosis (0-5, > 5-10, and > 10 years). Overall, 1777 patients with HL (42% of 4156 invited) and 6166 matched comparators (14% of 41 558 invited) responded, and median age was similar (HL: 59, comparators: 61). Most had classical HL (92%). HL groups had consistently and significantly lower QoL than their respective comparators, with 0-5, > 5-10, and > 10 years post-diagnosis MDs of -0.27, -0.28, and -0.24 for the HeartQoL, -7.4, -7.6, and -5.6 points for the QLQ-C30 summary score, -4.5, -4.9, and -4.2 points for the SF-36 physical component summary, and -0.05, -0.05, and -0.04 for the EQ-5D index. The relative difference between the HL group and comparators decreased from baseline to > 10 years post-diagnosis, but differences remained clinically important. The most pronounced symptoms were fatigue and dyspnea. To summarize, persons with HL experience reductions in QoL compared with the general population, even > 10 years post-diagnosis. The observed differences were clinically relevant within several domains and emphasize the need for a multidisciplinary approach to survivorship care.