Quality of life in 269 patients with poor-risk diffuse large B-cell lymphoma treated with rituximab versus observation after autologous stem cell transplant

Abstract

We aimed to assess quality of life (QoL) following front-line autologous stem cell transplant (ASCT) and the QoL relationship with rituximab maintenance, in patients with diffuse large B-cell lymphoma. Patients were then randomized to either one weekly rituximab injection for 4 weeks, or observation alone. Patients (n = 269) were given the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaires. Scales for all symptoms exhibited similar temporal patterns, with a marked increase, followed by a plateau after 1 year. The proportion of patients with a clinically significant improvement varied from 6% (constipation) to 56% (fatigue). Age, gender, and previous treatment-induced toxicities were not predictive of variations in QoL. Rituximab significantly reduced pain and symptom severity. Our results for QoL showed that patients experienced rapid recovery after ASCT in all the domains tested. Differences in QoL improvement with time were not connected with rituximab maintenance.

Keywords:

• Lymphoma
• quality of life
• rituximab maintenance
• autotransplant

Acknowledgements

The authors thank GELARC (Groupe d'Etude des Lymphomes de l'Adulte – Recherche Clinique) for the clinical management of this work.

We also thank all the pathologists involved in the study for their pathologic reviews, especially Josette Brière and Philippe Gaulard.

The following clinicians actively participated in the LNH 98-3-trial: N. Albin, D. Assouline, B. Audhuy, M. Azagury, K. Belhadj, M. Kuentz, M. Blanc, S. Bologna, D. Bordessoulle, R. Bouabdallah, F. Boué, S. Cailleres, P. Carde, O. Casasnovas, J. P. Cassuto, S. Castaigne, B. Chauffert, L. Chauvenet, B. Christian, J. Collignon, T. Cosnard, H. Cure, D. Decaudin, R. Delarue, A. Delmer, V. Delwail, H. Demuynck, B. De Prijck, T. De Revel, H. Dombret, F. Dreyfus, J. C. Eisenmann, M. Fabbro, G. Fillet, O. Fitoussi, M. Flesch, N. Frenkiel, C. Fruchart, H. Gonzalez, M.C. Gouttebel, F. Guilmin, O. Hermine, A. Huyn, E. Jourdan, P. Lederlin, I. Leduc, F. Lejeune, G. Lepeu, X. Levaltier, M. Macro, M. Maerevoet, L. Marechal, G. Marit, C. Martin, P. Morel, J. N. Munck, H. Naman, G. Nedellec, S. Nunhuck, F. Offner, H. Orfeuvre, J. M. Pavlovitch, P. Y. Péaud, A. M. Peny, P. Pierre, I. Plantier, C. Platini, M. Puntous, B. Quesnel, C. Rose, B. Salles, G. Salles, G. Sebahoun, C. Sebban, M. Simon, C. Sohn, C. Soussain, A. Thyss, C. Traulle, B. Valenza, X. Vallantin, E. Vandenneste, A. VanHoof, A. Vermeulen, M. Wetterwald, and M. Zini.

This work was supported by PHRC-AOM 98-117.

Potential conflict of interest:

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