: Late toxicity and quality of life (QOL) after treatment for Hodgkin disease (HD): A Gruppo Italiano Studio Linfomi (GISL) cohort study on 223 patients

Background: Because of successful treatment, a large number of HD patients becomelong term survivors and remain at life-long risk for late sequelae that could impairQOL. Aims of this study were to assess late toxicity and to evaluate the QOL.Patients and Method: GISL maintains a central database on characteristics, treatments,outcome and follow up (FU) of patients who entered clinical trial. For thisretrospective study, we extracted data on 223 patients. To evaluate QOL patients weregiven a questionnaire with 21 items, evaluating different psychical spheres, includingrelational, affective, emotional and behaviour areas.Result: 208 patients achieved complete response (CR); relapses occurred in 35 patientsof which16 obtained a 2 CR. After a median FU of 149 months, 168 patients are aliveand 53 died: 22 for progressive disease, 14 for 2 tumours, 6 for cardiac disease, 3 forrespiratory failure, 2 for infection and 6 for unknown causes. Two patients were lost atFU. Overall, late toxicity was observed in 82 patients of which 29 developed a 2tumours and 51 non-malignant toxicity, including cardiac and pulmonary diseases,endocrinal dysfunction, fertility anomalies, gastric disturbances and infections. Theevaluation of QOL is still ongoing and at this time 92 patients have filled out thequestionnaire, principally reporting alteration of adaptation and relational spheres.Conclusion: Late sequelae is an important concern, in particular because of the highnumber of 2 cancer and cardiac and pulmonary diseases. Further, although our dataon QOL are still incomplete, they showed that side effects may heavily impact on QOL,worsening adaptation and relational spheres. An accurate evaluation of late sequelaeand its impact on QOL is important in order to balance treatment efficacy and toxicity.