Hodgkin Lymphoma Survivors Live With Long-Term Fatigue

A longitudinal study published in the Lancet Oncology identified a high incidence of severe and persistent fatigue in Hodgkin lymphoma (HL) survivors.

Stefanie Kreissl, MD, from the University Hospital of Cologne in Germany, and authors reviewed data from 4,215 patients (18-60 years old) with early-stage favorable, early-stage unfavorable, and advanced-stage HL who were enrolled in three prospective, randomized, controlled clinical trials as part of the German Hodgkin Study Group. The authors then assessed patients’ fatigue levels from diagnosis to five years after diagnosis, using the European Organization for Research and Treatment of Cancer questionnaire’s fatigue scale (scores range from 0-100, with 100 being the highest level of fatigue).

Baseline fatigue was higher in patients who had a higher tumor burden, with mean fatigue scores of 30.8, 39.8, and 49, respectively (p values not available). In the second year, fatigue scores were 28.5, 28.8, and 30.7 (p values not available). By year five, the fatigue scores were 30.8, 27.1, and 28.2. Factors significantly associated with persistent fatigue included baseline fatigue (p<0.0001) and increasing age (p<0.0001).

Severe fatigue was recorded in 24 percent of patients (n=172/728) with early-stage favorable HL, 37 percent of those (n=481/1,307) with early-stage unfavorable HL, and 48 percent of those (n=654/1,357) with advanced-stage HL.

“Around 15 to 25 percent [of patients] throughout all stages suffered from severe fatigue, which means that they are not able to handle their everyday life activities,” said Dr. Kreissl. “Further, 30 to 40 percent suffered from less severe, but still clinically relevant, fatigue. Cancer-related fatigue, therefore, should be considered a distinct diagnosis and not only a symptom, and intervention strategies are urgently needed.”

Source: Kreissl S, Mueller H, Goergen H, et al. Cancer-related fatigue in patients with and survivors of Hodgkin’s lymphoma: A longitudinal study of the German Hodgkin Study Group. Lancet Oncol. 2016 September 6. [Epub ahead of print]