Quality of Life Evaluation in Patients with Follicular Cell Lymphoma: A Real-World Study in Europe and the United States

Overview

Journal Adv Ther

Date 2024 Jul 8

PMID 38976122

Authors

Patrick Connor Johnson

Abigail Bailey

Qiufei Ma

Neil Milloy

Emilia Biondi

Ruben G W Quek

Sarah Weatherby

Sophie Barlow

Affiliations

Soon will be listed here.

Abstract

Introduction: Follicular lymphoma (FL) is an indolent subtype of non-Hodgkin's lymphoma (NHL), characterized by a long natural course of remissions/relapses. We aimed to evaluate real-world quality of life (QoL) in patients with FL, by line of therapy (LOT), and across countries.

Methods: Data were drawn from the Adelphi FL Disease Specific Programme™, a cross-sectional survey of physicians and their patients in Europe [France, Germany, Italy, Spain, the United Kingdom (UK)], and the United States (US) from June 2021 to January 2022. Patients provided demographics and patient-reported outcomes via the European Organisation for Research and Treatment of Cancer QoL questionnaire (EORTC QLQ-C30). Bivariate analysis assessed QoL versus NHL, across LOT [first line (1L), second line (2L), third line or later (3L+)] and country.

Results: Patients (n = 401) had a mean [standard deviation (SD)] age of 66.0 (9.24) years, 58.1% were male, and 41.9%/22.9% were Ann Arbor stage III/IV. Patients with FL mean EORTC global health status (GHS)/QoL, nausea/vomiting, pain, dyspnea, appetite loss, and diarrhea scores were statistically significantly worse (p < 0.05) versus the NHL reference values. Mean (SD) GHS/QoL worsened from 1L [56.5 (22.21)] to 3L+ [50.4 (20.11)]. Physical and role functioning, fatigue, pain, dyspnea, and diarrhea scores also significantly worsened across later LOTs (p < 0.05). Across all functional domains, mean scores were significantly lower (p < 0.05) and almost all symptom scores (excluding diarrhea) were significantly higher (p < 0.05) for European versus US patients.

Conclusions: Patients with FL at later LOTs had significantly worse scores in most QoL aspects than earlier LOTs. European patients had significantly lower functioning and higher symptom burden than in the US. These real-world findings highlight the need for novel FL therapies that alleviate patient burden, positively impacting QoL.

Citing Articles

Unmet Needs and Health-Related Quality of Life Among Patients With Relapsed/Refractory Indolent Non-Hodgkin Lymphoma: A Mixed-Methods Study.

Sugimoto M, Yagasaki K, Matsuki E, Shimizu T, Sakurai M, Kataoka K Psychooncology. 2025; 34(2):e70103.

PMID: 39915950 PMC: 11803132. DOI: 10.1002/pon.70103.

References

Adkins S . CAR T-Cell Therapy: Adverse Events and Management. J Adv Pract Oncol. 2021; 10(Suppl 3):21-28. PMC: 7521123. DOI: 10.6004/jadpro.2019.10.4.11. View

Abramson J, Palomba M, Gordon L, Lunning M, Wang M, Arnason J . Lisocabtagene maraleucel for patients with relapsed or refractory large B-cell lymphomas (TRANSCEND NHL 001): a multicentre seamless design study. Lancet. 2020; 396(10254):839-852. DOI: 10.1016/S0140-6736(20)31366-0. View

Holdsworth E, Donaghy B, Fox K, Desai P, Collier D, Furst D . Biologic and Targeted Synthetic DMARD Utilization in the United States: Adelphi Real World Disease Specific Programme for Rheumatoid Arthritis. Rheumatol Ther. 2021; 8(4):1637-1649. PMC: 8572299. DOI: 10.1007/s40744-021-00357-1. View

Leith A, Kim J, Ribbands A, Clayton E, Yang L, Ghate S . Real-World Treatment Patterns in Metastatic Castration-Resistant Prostate Cancer Across Europe (France, Germany, Italy, Spain, and the United Kingdom) and Japan. Adv Ther. 2022; 39(5):2236-2255. PMC: 9056448. DOI: 10.1007/s12325-022-02073-w. View

Bachy E, Seymour J, Feugier P, Offner F, Lopez-Guillermo A, Belada D . Sustained Progression-Free Survival Benefit of Rituximab Maintenance in Patients With Follicular Lymphoma: Long-Term Results of the PRIMA Study. J Clin Oncol. 2019; 37(31):2815-2824. PMC: 6823890. DOI: 10.1200/JCO.19.01073. View

Zhao H, Xiao Z, Zhang L, Ford J, Zhong S, Ye W . Real-World Treatment Patterns and Outcomes Among Patients with Episodic Migraine in China: Results from the Adelphi Migraine Disease Specific Programme™. J Pain Res. 2023; 16:357-371. PMC: 9904300. DOI: 10.2147/JPR.S371887. View

Despiegel N, Touboul C, Flinois A, Saba G, Suzan F, Gonzalez-McQuire S . Health-Related Quality of Life of Patients With Multiple Myeloma Treated in Routine Clinical Practice in France. Clin Lymphoma Myeloma Leuk. 2018; 19(1):e13-e28. DOI: 10.1016/j.clml.2018.08.019. View

Kiserud C, Lockmer S, Baerug I, Dahl A, Kimby E, Ostenstad B . Health-related quality of life and chronic fatigue in long-term survivors of indolent lymphoma - a comparison with normative data. Leuk Lymphoma. 2022; 64(2):349-355. DOI: 10.1080/10428194.2022.2142050. View

Picardi M, Giordano C, Pepa R, Cerchione C, Pugliese N, Leone A . Correspondence in reference to previously published manuscript: "Faouzi Djebbari et al. Efficacy and infection morbidity of front-line immuno-chemotherapy in follicular lymphoma. Eur J Haematol. 2020; 105: 667-671". Eur J Haematol. 2020; 106(5):734-736. PMC: 8248065. DOI: 10.1111/ejh.13558. View

10.

Giesinger J, Kuijpers W, Young T, Tomaszewski K, Friend E, Zabernigg A . Thresholds for clinical importance for four key domains of the EORTC QLQ-C30: physical functioning, emotional functioning, fatigue and pain. Health Qual Life Outcomes. 2016; 14:87. PMC: 4897949. DOI: 10.1186/s12955-016-0489-4. View

11.

Cartron G, Trotman J . Time for an individualized approach to first-line management of follicular lymphoma. Haematologica. 2022; 107(1):7-18. PMC: 8719078. DOI: 10.3324/haematol.2021.278766. View

12.

Mahtani R, Niyazov A, Lewis K, Rider A, Massey L, Arondekar B . Real-World Study of Regional Differences in Patient Demographics, Clinical Characteristics, and BRCA1/2 Mutation Testing in Patients with Human Epidermal Growth Factor Receptor 2-Negative Advanced Breast Cancer in the United States, Europe, and.... Adv Ther. 2022; 40(1):331-348. PMC: 9859923. DOI: 10.1007/s12325-022-02302-2. View

13.

Hiddemann W, Kneba M, Dreyling M, Schmitz N, Lengfelder E, Schmits R . Frontline therapy with rituximab added to the combination of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) significantly improves the outcome for patients with advanced-stage follicular lymphoma compared with therapy with CHOP.... Blood. 2005; 106(12):3725-32. DOI: 10.1182/blood-2005-01-0016. View

14.

Matasar M, Luminari S, Barr P, Barta S, Danilov A, Hill B . Follicular Lymphoma: Recent and Emerging Therapies, Treatment Strategies, and Remaining Unmet Needs. Oncologist. 2019; 24(11):e1236-e1250. PMC: 6853118. DOI: 10.1634/theoncologist.2019-0138. View

15.

Osoba D, Rodrigues G, Myles J, Zee B, Pater J . Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol. 1998; 16(1):139-44. DOI: 10.1200/JCO.1998.16.1.139. View

16.

Johnsen A, Tholstrup D, Petersen M, Pedersen L, Groenvold M . Health related quality of life in a nationally representative sample of haematological patients. Eur J Haematol. 2009; 83(2):139-48. PMC: 2730555. DOI: 10.1111/j.1600-0609.2009.01250.x. View

17.

Welaya K, Casulo C . Follicular Lymphoma: Redefining Prognosis, Current Treatment Options, and Unmet Needs. Hematol Oncol Clin North Am. 2019; 33(4):627-638. DOI: 10.1016/j.hoc.2019.03.003. View

18.

Higgins V, Piercy J, Roughley A, Milligan G, Leith A, Siddall J . Trends in medication use in patients with type 2 diabetes mellitus: a long-term view of real-world treatment between 2000 and 2015. Diabetes Metab Syndr Obes. 2016; 9:371-380. PMC: 5098530. DOI: 10.2147/DMSO.S120101. View

19.

Pettengell R, Donatti C, Hoskin P, Poynton C, Kettle P, Hancock B . The impact of follicular lymphoma on health-related quality of life. Ann Oncol. 2007; 19(3):570-6. DOI: 10.1093/annonc/mdm543. View

20.

Chen X, Li P, Tian B, Kang X . Serious adverse events and coping strategies of CAR-T cells in the treatment of malignant tumors. Front Immunol. 2022; 13:1079181. PMC: 9772271. DOI: 10.3389/fimmu.2022.1079181. View