Health-related quality of life and chronic fatigue in long-term survivors of indolent lymphoma – a comparison with normative data

Figures & data

Table 1. Description of the sample (N = 136).

Variables	N = 136
Sex, n (%)
Men	61 (45)
Women	75 (55)
Country, n (%)
Sweden	84 (62)
Norway	52 (38)
Median age (range)	56 (23–79)
Types of lymphomas, n (%)
Follicular lymphoma grade 1	57 (42)
Follicular lymphoma grade 2	59 (43)
Follicular lymphoma grade 3a	5 (4)
MZL	9 (7)
Low-grade lymphoma NOS	6 (4)
Stage at inclusion in the clinical trials, n (%)
II	9 (7)
III	48 (35)
IV	78 (57)
Not known	1 (1)
Chlorambucil pre-inclusion	14 (10)
Radiotherapy pre-inclusion	16 (12)
Treatment after first-line trial therapy, n (%)
Chemotherapy/immune-chemotherapy	78 (57)
+Allo-SCT	3 (2)
+Auto-SCT	21 (15)
Transformation after first-line trial therapy, n (%)	22 (16)
Another cancer later on, n (%)	16 (12)
Anemia, Hb < 120 g/L	21 (15)
Somatic comorbidity at survey*, n (%)
No comorbidity	37 (27)
One comorbidity	53 (39)
Two–five comorbidities	46 (34)
Poor dental health, n (%)	42 (31)
Cognitive problems, n (%)	83 (61)
Civil status, n (%)
Partner	104 (77)
Non-partner	32 (23)
Level of education, n (%)
≤12 years	90 (66)
≥13 years	45 (33)
Work status at survey, n (%)
Paid work	56 (42)
Sick-leave, sick pension	12 (9)
Retirement pension	67 (49)
Work ability, mean ± sd
At diagnosis	7.7 (3.3)**
At survey	6.7 (3.0)
Fatigue	12.9 (5.2)
Total fatigue score, mean ± sd	24 (18)
Chronic fatigue cases, n (%)
HADS anxiety case, n (%)	17 (13)
HADS depression case, n (%)	11 (8)
Obesity (BMI ≥ 30), n (%)	14 (10)
	N = 119
Fulfill physical activity recommendations, N (%)	49 (36)

*Self-reported at survey, **Paired sample t-test at diagnosis versus at survey p = 0.010.

MZL:marginal zone lymphoma, NOS: not otherwise spesified, Allo-SCT: allogeneic stem cell transplantation, Auto-SCT: autologous stem cell transplantation, Hb: hemoglobine, HADS: Hospital Anxiety and Depression Scale, BMI: Body Mass Index

Table 2. Comparison of patients and NORMs of the SF-36 dimensions and Fatigue Questionnaire (FQ).

SF-36 dimensions	Patients (N = 136) Mean (SD)	NORMs (N = 680) Mean (SD)	p Value	Effect size
Physical function	78.7 (21.1)	88.2 (17.3)	<0.001	0.53
Role physical	65.8 (40.3)	78.5 (35.7)	0.002	0.35
Bodily pain	70.8 (25.9)	68.7 (24.7)	0.367	0.08
General health	64.7 (23.8)	74.1 (20.7)	<0.001	0.44
Vitality	64.1 (22.2)	60.8 (20.1)	0.086	0.16
Social function	85.1 (23.4)	89.0 (19.4)	0.039	0.19
Role emotional	82.8 (34.7)	90.8 (24.6)	0.001	0.30
Mental health	82.3 (18.1)	82.2 (13.7)	0.942	0.01
PCS	44.8 (10.5)	48.5 (10.0)	<0.001	0.37
MCS	54.7 (10.1)	53.6 (8.1)	0.167	0.13
Fatigue
Mental fatigue	4.3 (1.7)	4.1 (1.5)	0.166	0.13
Physical fatigue	8.6 (4.0)	7.7 (3.1)	0.003	0.28
Total fatigue	12.9 (5.2)	11.5 (4.1)	0.001	0.33
Chronic fatigue, N (%)	24 (18)	74 (11)	0.031	NA*

*NA not applicable.

p-value <0.01 considered statistically significant. Effect size values > 0.29 considered clinically significant.

Table 3. Uni- and multivariable linear regression analyses of independent variables and SF-36 PCS as dependent variable (N = 136).

	Univariable analyses		Multivariable analysis
Variables	B*	p Value	B*	p Value
Age at survey	−0.18	0.04	0.026	0.78
Supplementary treatment	−3.28	0.11	–	–
Second cancer	−4.88	007	–	–
Comorbidities	–	–	–	–
None (reference)	–	–	–	–
1-2	−7.68	<0.001	−6.1	0.01
3 +	−10.81	<0.001	−9.1	<0.001
Females (males reference)	−0.49	0.79	–	–
Non-paired relationship	−0.99	0.64	–	–
Low basic education	−4.68	0.01	−1.9	0.25
Not in paid work	−2.66	0.006	−6.0	0.003
Chronic fatigue case	−12.94	<0.001	−10.9	<0.001
Anxiety score	−0.56	0.02	–	–
Depression score	−1.21	<0.001	–	–
Poor dental health	2.04	0.30	–	–
Cognitive problems	−2.46	0.18	–	–

B*= unstandardized beta.

Table 4. Uni- and multivariable linear regression analyses of independent variables and SF-36 MCS as dependent variable (N = 136).

	Univariable analyses		Multivariable analysis
Variables	B*	p Value	B*	p Value
Age at survey	0.20	0.02	0.09	0.07
Supplementary treatment	1.52	0.43
Second cancer	1.61	0.54
Comorbidities
None (reference)
1-2	–3.38	0.12
3 +	–1.26	0.57
Females (males reference)	–0.87	0.62
Non-paired relationship	–5.02	0.01	–0.37	0.77
Low basic education	–0.45	0.81
Not in paid work	1.40	0.13
Chronic fatigue case	–2.21	0.32
Anxiety score	–2.13	<0.001	–1.61	<0.001
Depression score	–1.95	<0.001	–0.73	<0.001
Poor dental health	–3.73	0.05
Cognitive problems	–3.36	0.06

B* = unstandardized beta.