Aaron M Tarnasky1, Jesse D Troy2, Thomas W LeBlanc3,4. 1. Duke University School of Medicine, Durham, USA. 2. Division of Biostatistics, Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, 27710, USA. 3. Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC, 27710, USA. thomas.leblanc@duke.edu. 4. Duke Cancer Institute, Box 2715, DUMC,, Durham, NC, 27710, USA. thomas.leblanc@duke.edu.
Abstract
PURPOSE: Psychological distress is prevalent in Hodgkin lymphoma (HL). Many patients, regardless of prognosis, receive ABVD chemotherapy as first-line treatment, but few studies have specifically examined the nature of distress during this shared treatment experience. METHODS: We conducted a retrospective study of patient-reported distress in HL patients receiving ABVD treatment at a single tertiary care facility. Distress was measured using the National Comprehensive Cancer Network Distress Thermometer and Problem List (PL). We used descriptive statistics and generalized estimating equations to assess the prevalence of distress and specific problem items during treatment and associations with patient- and disease-related factors. RESULTS: We collected data from 50 patients comprising 467 unique encounters, with 369/467 (79.0%) reporting a distress thermometer score. Median distress score was 2 (IQR: 0-5), but actionable distress (distress thermometer ≥4) was noted for 118/369 (32.0%) encounters. Actionable distress was only related to having a prior cancer, which conferred lower odds of actionable distress (OR 0.23, 95% CI 0.07-0.74, p=0.01) Physical and emotional problems were reported for 287/369 (77.8%) and 125/369 (33.9%) visits, respectively. Female patients had greater odds of both physical (OR 3.17, 95% CI 1.32-7.66, p=0.01) and emotional (OR 3.31, 95% CI 1.25-8.73, p=0.02) problems. CONCLUSION: ABVD treatment is associated with a high frequency of actionable distress, with physical and emotional problems acting as primary drivers. Female patients may be particularly vulnerable, while cancer survivors may be uniquely resilient. These findings demonstrate the need to thoroughly screen for and appropriately tailor distress management strategies for HL patients during treatment with ABVD.
PURPOSE: Psychological distress is prevalent in Hodgkin lymphoma (HL). Many patients, regardless of prognosis, receive ABVD chemotherapy as first-line treatment, but few studies have specifically examined the nature of distress during this shared treatment experience. METHODS: We conducted a retrospective study of patient-reported distress in HLpatients receiving ABVD treatment at a single tertiary care facility. Distress was measured using the National Comprehensive Cancer Network Distress Thermometer and Problem List (PL). We used descriptive statistics and generalized estimating equations to assess the prevalence of distress and specific problem items during treatment and associations with patient- and disease-related factors. RESULTS: We collected data from 50 patients comprising 467 unique encounters, with 369/467 (79.0%) reporting a distress thermometer score. Median distress score was 2 (IQR: 0-5), but actionable distress (distress thermometer ≥4) was noted for 118/369 (32.0%) encounters. Actionable distress was only related to having a prior cancer, which conferred lower odds of actionable distress (OR 0.23, 95% CI 0.07-0.74, p=0.01) Physical and emotional problems were reported for 287/369 (77.8%) and 125/369 (33.9%) visits, respectively. Female patients had greater odds of both physical (OR 3.17, 95% CI 1.32-7.66, p=0.01) and emotional (OR 3.31, 95% CI 1.25-8.73, p=0.02) problems. CONCLUSION: ABVD treatment is associated with a high frequency of actionable distress, with physical and emotional problems acting as primary drivers. Female patients may be particularly vulnerable, while cancer survivors may be uniquely resilient. These findings demonstrate the need to thoroughly screen for and appropriately tailor distress management strategies for HLpatients during treatment with ABVD.
Authors: Paul A Harris; Robert Taylor; Robert Thielke; Jonathon Payne; Nathaniel Gonzalez; Jose G Conde Journal: J Biomed Inform Date: 2008-09-30 Impact factor: 6.317
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Authors: Natacha Heutte; Henning H Flechtner; Nicolas Mounier; Wilhelmina A M Mellink; Jacobus H Meerwaldt; Houchingue Eghbali; Mars B van't Veer; Evert M Noordijk; Johanna C Kluin-Nelemans; Elzbieta Lampka; José Thomas; Pieternella J Lugtenburg; Luisa Viterbo; Patrice Carde; Anton Hagenbeek; Richard Wm van der Maazen; Wilma G J M Smit; Pauline Brice; Marinus van Marwijk Kooy; Johanna W Baars; Philip Poortmans; Umberto Tirelli; Onno C Leeksma; Radka Tomsic; Pierre Feugier; Gilles Salles; Jean Gabarre; Marie José Kersten; Eric Van Den Neste; Geert-Jan M Creemers; Isabelle Gaillard; Paul Meijnders; Gérard Tertian; Oumédaly Reman; Hein P Muller; Jacques Troncy; Michel Blanc; Wilfried Schroyens; Paul J Voogt; Pierre Wijermans; Chantal Rieux; Christophe Fermé; Michel Henry-Amar Journal: Lancet Oncol Date: 2009-10-12 Impact factor: 41.316