Abstract

Background Numerous treatment options are available for patients with indolent lymphoma (IL), including active treatment and active observation without initiation of therapy, watchful waiting; each is associated with unique, longer term therapeutic and health-related quality of life (HRQL) consequences. We sought to identify key HRQL domains of importance to patients with indolent lymphoma and whether HRQL varies by treatment.

Methods Five focus groups (n=33), supplemented by in-depth one-on-one telephone interviews (n=19) were conducted with IL patients across the US. Patients completed a questionnaire composed of five standard validated instruments related to physical well-being, social/family well-being, emotional well-being, functional well-being (FACT-G), additional concerns (FACT-Lym), physical appearance, psychosocial adaptation to illness (PAIS), and mental health (MHI-5). Questionnaire domains were scored on a 0–100 scale where higher scores indicate better functioning.

Results A total of 52 IL patients (65% female; mean age 53 years) completed the questionnaire. Participants belonged to one of the following treatment categories: Active Treatment (n=18), Previous Treatment (n=25) and Watchful Waiting (n=9). Similarities in FACT scores were found between the Previous Treatment and Watchful Waiting groups. The Watchful Waiting group scored the lowest on both the MHI-5 and the PAIS. Differences were found in Physical Well-Being between the Active Treatment and Previous Treatment groups (67.06 vs. 81.10, respectively, p=0.029). Differences were observed for the PAIS between the Active Treatment and Watchful Waiting groups (83.82 vs. 65.63, respectively, p=0.021) and between the Previous Treatment and Watchful Waiting groups (85.00 vs. 65.63, respectively, p=0.010).

Conclusions Preliminary findings suggest that differences were observed between patients on active treatment, those who have previously been treated and patients who have never been treated, watchful waiting. Further elucidation of these issues is needed to facilitate HRQL evaluation in future studies and more importantly better inform patients and providers of treatment decisions.

Table 1.

Mean (Standard Deviation) HRQL Scores of all Patients and by Treatment Categories

DomainsAll Patients (N=52)Active Treatment (N=18)Previous Treatment (N=25)Watchful Waiting (N=9)
FACT-G 73.01 (15.56) 67.41 (15.82) 76.21 (14.12) 75.67 (17.30) 
FACT-Lym 71.35 (15.25) 67.63 (16.09) 73.11 (12.39) 75.02 (18.58) 
Physical Appearance 76.85 (29.36) 65.00 (31.62) 82.69 (27.74) 87.50 (25.00) 
PAIS 81.50 (18.77) 83.82 (16.40) 85.00 (18.40) 65.63 (18.60) 
MHI-5 69.08 (18.00) 69.33 (15.22) 71.36 (18.46) 62.22 (21.92) 
DomainsAll Patients (N=52)Active Treatment (N=18)Previous Treatment (N=25)Watchful Waiting (N=9)
FACT-G 73.01 (15.56) 67.41 (15.82) 76.21 (14.12) 75.67 (17.30) 
FACT-Lym 71.35 (15.25) 67.63 (16.09) 73.11 (12.39) 75.02 (18.58) 
Physical Appearance 76.85 (29.36) 65.00 (31.62) 82.69 (27.74) 87.50 (25.00) 
PAIS 81.50 (18.77) 83.82 (16.40) 85.00 (18.40) 65.63 (18.60) 
MHI-5 69.08 (18.00) 69.33 (15.22) 71.36 (18.46) 62.22 (21.92) 

Disclosures: Deborah P. Lubeck and Carolina M. Reyes are full-time employees of Genentech, Inc.; Susan D. Mathias, Tricia A. Cimms and Hilary H. Colwell were consultants to Genentech, Inc.; This applies to Deborah P. Lubeck and Carolina M. Reyes who are employees of Genentech, Inc. and who have been granted stock options.

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