aot2022v55i2

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Acta Oncologica Turcica 2022; 55: 128-138136subgroups in terms of HL27 SB, PC, EI andWF scores . (p>0.05) (Table 4).There was also no significant differencebetween HL subtypes in terms of QLQ-C30global health status/ QoL, functional orsymptom scales; of HL27 SB, PC, EI and WFscores (p>0.05) (Table 5).DiscussionOur study is the first from Turkey to evaluateQoL using QLQ-C30 and QLQ-HL27 in alarge and multi-center HL patient group.There is limited information on the use ofQLQ subtypes in hematological malignanciesand no clear evidence for their effectiveness.In a recent study from 2020 [10], healthrelatedQoL (HRQoL) was evaluated usingthe EORTC QLQ-C30 in a total of 515hematological malignancies diagnosed withleukemia, lymphoma and multiple myelomaover the age of 18 years. Of the 515 patientsincluded in the study, 46.6% were diagnosedwith lymphoma, 34% with leukemia and19.4% with multiple myeloma; 70.9% of themwere with advanced-stage or high risk.Anxiety rate was 15.1% and depression12.8%. While the mean global health statusscore was found to be 59.6 in our study, it wasfound to be 59.2 in this study. In our study,there was no significant difference betweenage subgroups, stages and disease subtypes interms of the global health scores/QoL.In an HL cohort from 2020 [11], patients withadvanced HL, 5-year HL-survivors and thegeneral population were compared with eachother. Patients reported worse HRQoL scoresthan survivors across most functional scalesand symptom scales. These scores varied as afunction of gender but not age. Survivors'HRQoL reports were comparable to the onesof the general population. In addition, eventhough the QoL scores of HL patients areworse than the general population, theyimprove over the years.In another study from Turkey in 2020 [12], ina group of 121 chronic myeloid leukemiapatients, who had used a tyrosine kinaseinhibitor (TKI) for at least 3 months, the effectivenessof QLQ-C30 and QLQ-CML24 wasexamined. While the median age of thepatients was 53, there was no difference inglobal health status scores between patientswho received different TKIs. In the QLQ-CML24 module, the most common symptomwas fatigue with 58.7%; there was nosignificant difference between the TKI groupsin terms of the effect on activities of dailyliving. In our study in the HL patient group,the median age was 40, and there was nosignificant difference between the groups weformed in terms of QLQ-C30 and QLQ-HL27parameters. A statistically significantdifference was found only in terms of QLQ-C30 constipation sub-dimension scoresaccording to gender (p=0.041). Another majorstudy [13] included adults aged 18 years andolder who had completed treatment for ahema-tological malignancy and were at 1 to 5years post-treatment. In a total of 131 patientswith a mean age of 66, being advanced agewas found to be associated with poor QoL.Males reported better physical functioning,fewer pain symptoms, and less insomniacompared to females. While the median age ofthe study was 66, 77.9% of them werediagnosed with lymphoma (B-cell). In ourstudy, the only difference between males andfemales was consti-pation. The median agewas 40 years due to the younger age group ofHL. In another study involving 490 patientsfrom 40 different centers with a diagnosis ofmultiple myeloma, which is seen as a diseaseof the older age group [14], the median agewas 71 and the mean global health status scorewas 49.4. In the patient group followed in theno-treatment interval, the global health statusscores and functional scores were better andfewer symptoms were observed.www.actaoncologicaturcica.comCopyright©Ankara Onkoloji Hastanesi
Acta Oncologica Turcica 2022; 55: 128-138137In another MM cohort, a total of 445 patientswere evaluated; a high global health status/QoL score has been shown to be associatedwith good treatment response and fewer sideeffects; it was also observed that an increasein the score was significantly associated withlonger treatment [15]. In our study, the factthat the general health status scores and QLQ-C30 or HL27 parameters did not differsignificantly in patients who were with moreadvanced stages and needed longer treatmentshould be considered as an important result.According to MM, which is a disease ofadvanced age; it is important in terms oftreatment tolerance in HL where young age isdominant.There are also limitation points of this study.The most important one is the fact that validityand reliability study of the EORTC QLQ-HL27 was not done in Turkish language.Another important points were the limitedpatient population and statistical analysis,which became difficult especially when subgroupswere established.As a result, this study is the first from ourcountry to evaluate the QLQ-C30 and QLQ-HL27 questionnaires, especially in a relativelyyoung patient population com-pared to otherhematologic malignancies of literature. Therewas no significant differ-ence between age,gender and stage subgroups in terms of QLQ-C30 and QLQ-HL27 sub-parameters. Therewas only a statistically significant differencein terms of QLQ-C30 constipation subdimensionscores according to gender. Theconstipation scores of females were higherthan the scores of men. More detailed andlarge population studies are needed to revealthe effectiveness of QoL assessment in HLpatients.REFERENCES1. Ansell SM. Hodgkin Lymphoma: Diagnosis andTreatment. Mayo Clin Proc. 2015; 90(11): 1574-83.2. Türk Hematoloji Derneği Lenfoma Tanı ve TedaviKılavuzu, Sürüm 1.4 - EKİM 20203. Ansell SM. Hodgkin lymphoma: 2018 update ondiagnosis, risk-stratification, and management. Am JHematol. 2018; 93(5): 704-715.4. Kreissl S, Müller H, Goergen H, et al. Health-RelatedQuality of Life in Patients with Hodgkin Lymphoma: ALongitudinal Analysis of the German Hodgkin StudyGroup. J Clin Oncol. 2020; 38(25): 2839-2848.5. Oerlemans S, Mols F, Nijziel MR, Lybeert M, van dePoll-Franse LV. The impact of treatment, sociodemographicand clinical characteristics on healthrelatedquality of life among Hodgkin's and non-Hodgkin's lymphoma survivors: a systematic review.Ann Hematol. 2011; 90(9): 993-1004.6. Trachtenberg E, Gurion R, Mashiach T, Tadmor T,Kedmi M, Dann EJ. Recognizing severe fatigue anddecline in quality of life in Hodgkin lymphomasurvivors. Leuk Lymphoma. 2019; 60(14): 3449-3454.www.actaoncologicaturcica.com7. Linendoll N, Saunders T, Burns R, et al. Healthrelatedquality of life in Hodgkin lymphoma: asystematic review. Health Qual Life Outcomes. 2016;14(1): 114.8. Behringer K, Goergen H, Müller H, et al. Cancer-Related Fatigue in Patients with and Survivors ofHodgkin Lymphoma: The Impact on TreatmentOutcome and Social Reintegration. J Clin Oncol. 2016;34(36): 4329-4337.9.Van de Poll-Franse L, Oerlemans S, Bredart A et al;EORTC Quality of Life Group. Internationaldevelopment of four EORTC disease-specific quality oflife questionnaires for patients with Hodgkinlymphoma, high- and low-grade non-Hodgkinlymphoma and chronic lymphocytic leukaemia. QualLife Res. 2018; 27(2): 333-345.10. Lòpez N, Montaño-Figueroa EH, Infante-CastañedaC, Pérez-Cuevas R. Experiences with health care andhealth-related quality of life of patients withhematologic malignancies in Mexico. BMC Health ServRes. 2020; 20(1): 644.11. Vachon H, Mierzynska J, Taye M, et al. Referencevalues for the EORTC QLQ-C30 in patients withCopyright©Ankara Onkoloji Hastanesi
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