Conduire des études épidémiologiques après cancer en France : modalités, difficultés et propositions de solutions. Les enseignements de l’étude SIMONAL sur les toxicités tardives des traitements du lymphome non Hodgkinien

Anthony, S.; Hebel, Pierre; Garrel, André; Oliveri, Vanina; Thiéblemont, Catherine; Ribrag, Vincent; Tilly, Hervé; Haı̈oun, Corinne; Casasnovas, Olivier; Morschhauser, Franck; Feugier, Pierre; Delarue, Richard; Ysebaert, Loïc; Sebban, Catherine; Broussais, Florence; Damaj, Gandhi; Nerich, Virginie; Jaı̈s, Jean-Philippe; Salles, Gilles; Henry-Amar, Michel; Mounier, Nicolas

doi:10.1016/j.bulcan.2017.01.007

Cited by 3 publications

(2 citation statements)

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“…We had the opportunity to develop two cross-sectional surveys with the aim to evaluate rehabilitation, health status, and long-term fatigue in survivors of lymphomas who participated in clinical protocols conducted by two European cooperative groups. In the two surveys, the same methodology and the same self-administered questionnaires were used [23, 24].…”

Section: Discussionmentioning

confidence: 99%

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Fatigue level changes with time in long-term Hodgkin and non-Hodgkin lymphoma survivors: a joint EORTC-LYSA cross-sectional study

Busson

Kaaij

Mounier

et al. 2019

Health Qual Life Outcomes

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Background Long-term lymphoma survivors often complain of persistent fatigue that remains unexplained. While largely reported in Hodgkin lymphoma (HL), long-term fatigue is poorly documented in non-Hodgkin lymphomas (NHL). Data collected in two cohort studies were used to illustrate the fatigue level changes with time in the two populations. Methods Two cross-sectional studies were conducted in 2009–2010 (HL) and in 2015 (NHL) in survivors enrolled in European Organisation for Research and Treatment of Cancer (EORTC) Lymphoma Group and Lymphoma Study Association (LYSA) trials. The same protocol and questionnaires were used in both studies including the Multidimensional Fatigue Inventory (MFI) tool to assess fatigue and a checklist of health disorders. Multivariate linear regression models were used in the two populations separately to assess the influence of time since diagnosis and primary treatment, age, gender, education level, cohabitation status, obesity and health disorders on fatigue level changes. Fatigue level changes were compared to general population data. Results Overall, data of 2023 HL and 1619 NHL survivors with fatigue assessment available (99 and 97% of cases, respectively) were analyzed. Crude levels of fatigue were similar in the two populations. Individuals who reported health disorders (61% of HL and 64% of NHL) displayed higher levels of fatigue than those who did not ( P < 0.001). HL survivors showed increasing fatigue level with age while in NHL survivors mean fatigue level remained constant until age 70 and increased beyond. HL survivors showed fatigue changes with age higher than those of the general population with health disorders while NHL survivors were in between those of the general population with and without health disorders. Conclusions Among lymphoma survivors progressive increase of fatigue level with time since treatment completion is a distinctive feature of HL. Our data suggest that changes in fatigue level are unlikely to only depend on treatment complications and health disorders. Investigations should be undertaken to identify which factors including biologic mechanisms could explain why a substantial proportion of survivors develop high level of fatigue.

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Section: Discussionmentioning

confidence: 99%

“…Survivors were eligible if they had no active lymphoma, had follow-up of 5 years or more, and were free from any cancer treatments since 4 years. Detailed descriptions of the cross-sectional studies were previously published [23, 24].…”

Section: Methodsmentioning

confidence: 99%

Fatigue level changes with time in long-term Hodgkin and non-Hodgkin lymphoma survivors: a joint EORTC-LYSA cross-sectional study

Busson

Kaaij

Mounier

et al. 2019

Health Qual Life Outcomes

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Long‐term fatigue in survivors of non‐Hodgkin lymphoma: The Lymphoma Study Association SIMONAL cross‐sectional study

Mounier¹,

Anthony

Busson³

et al. 2019

Cancer

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Background Long‐term survivors of non‐Hodgkin lymphoma (NHL) must cope with treatment complications and late toxicities that affect their health‐related quality of life. Little is known about the risk‐to‐benefit ratio of new agents like rituximab. The impact of treatment regimens and health disorders on long‐term fatigue levels was investigated in a cross‐sectional study. Methods Two self‐administered questionnaires, the 20‐item Multidimensional Fatigue Inventory (MFI‐20) and a Life Situation Questionnaire, were mailed in 2015 to NHL survivors enrolled onto 12 successive clinical studies (1993‐2010) conducted by the Lymphoma Study Association. Private addresses were obtained for 3317 survivors, of whom 1671 (50%) returned the questionnaires. Severe fatigue was defined as MFI‐20 scores ≥60 on dimension scales scored from 0 to 100. Linear regression models were used to assess factors that were linked to increased fatigue levels. Results The study population included 906 men and 765 women, and the median age was 64 years (age range, 24‐95 years). Overall, 811 survivors had received cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP)‐like chemotherapy, 518 had received high‐dose CHOP, and 342 had undergone upfront autologous stem cell transplantation; 829 survivors also had received rituximab. In total, 1100 survivors (66%) reported 1 or more late health disorders. Severe fatigue was reported by 602 survivors (37%). Increased fatigue levels were associated (P < .001) with increased age, obesity, and the presence of health disorders, but not with initial treatment or rituximab. Conclusions The survey confirms that high proportions long‐term NHL survivors have severe fatigue. The results suggest that initial treatment and the receipt of rituximab have no influence on the development of long‐term fatigue.

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Santé publique et volonté politique : convergences et divergences

2017

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Conduire des études épidémiologiques après cancer en France : modalités, difficultés et propositions de solutions. Les enseignements de l’étude SIMONAL sur les toxicités tardives des traitements du lymphome non Hodgkinien

Cited by 3 publications

References 3 publications

Fatigue level changes with time in long-term Hodgkin and non-Hodgkin lymphoma survivors: a joint EORTC-LYSA cross-sectional study

Fatigue level changes with time in long-term Hodgkin and non-Hodgkin lymphoma survivors: a joint EORTC-LYSA cross-sectional study

Long‐term fatigue in survivors of non‐Hodgkin lymphoma: The Lymphoma Study Association SIMONAL cross‐sectional study

Santé publique et volonté politique : convergences et divergences

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