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Modifiable risk factors for neurocognitive and psychosocial problems after Hodgkin lymphoma.

Publication ,  Journal Article
Williams, AM; Mirzaei Salehabadi, S; Xing, M; Phillips, NS; Ehrhardt, MJ; Howell, R; Yasui, Y; Oeffinger, KC; Gibson, T; Chow, EJ; Hudson, MM ...
Published in: Blood
May 19, 2022

Long-term survivors of childhood Hodgkin lymphoma (HL) experience a high burden of chronic health morbidities. Correlates of neurocognitive and psychosocial morbidity have not been well established. A total of 1760 survivors of HL (mean ± SD age, 37.5 ± 6.0 years; time since diagnosis, 23.6 ± 4.7 years; 52.1% female) and 3180 siblings (mean age, 33.2 ± 8.5 years; 54.5% female) completed cross-sectional surveys assessing neurocognitive function, emotional distress, quality of life, social attainment, smoking, and physical activity. Treatment exposures were abstracted from medical records. Chronic health conditions were graded according to the National Cancer Institute's Common Terminology Criteria for Adverse Events version 4.3 (1 = mild, 2 = moderate, 3 = severe/disabling, and 4 = life-threatening). Multivariable analyses, adjusted for age, sex, and race, estimated relative risk (RR) of impairment in survivors vs siblings and, among survivors, risk of impairment associated with demographic, clinical, treatment, and grade 2 or higher chronic health conditions. Compared with siblings, survivors had significantly higher risk (all, P < .05) of neurocognitive impairment (eg, memory, 8.1% vs 5.7%), anxiety (7.0% vs 5.4%), depression (9.1% vs 7%), unemployment (9.6% vs 4.4%), and impaired physical/mental quality of life (eg, physical function, 11.2% vs 3.0%). Smoking was associated with a higher risk of impairment in task efficiency (RR, 1.56; 95% confidence interval [CI], 1.02-2.39), emotional regulation (RR, 1.84; 95% CI, 1.35-2.49), anxiety (RR, 2.43; 95% CI, 1.51-3.93), and depression (RR, 2.73; 95% CI, 1.85-4.04). Meeting the exercise guidelines of the Centers for Disease Control and Prevention was associated with a lower risk of impairment in task efficiency (RR, 0.70; 95% CI, 0.52-0.95), organization (RR, 0.60; 95% CI, 0.45-0.80), depression (RR, 0.66; 95% CI, 0.48-0.92), and multiple quality of life domains. Cardiovascular and neurologic conditions were associated with impairment in nearly all domains. Survivors of HL are at elevated risk for neurocognitive and psychosocial impairment, and risk is associated with modifiable factors that provide targets for interventions to improve long-term functional outcomes.

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Published In

Blood

DOI

EISSN

1528-0020

Publication Date

May 19, 2022

Volume

139

Issue

20

Start / End Page

3073 / 3086

Location

United States

Related Subject Headings

  • Young Adult
  • Survivors
  • Risk Factors
  • Quality of Life
  • Neoplasms
  • Male
  • Immunology
  • Humans
  • Hodgkin Disease
  • Female
 

Citation

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Williams, A. M., Mirzaei Salehabadi, S., Xing, M., Phillips, N. S., Ehrhardt, M. J., Howell, R., … Krull, K. R. (2022). Modifiable risk factors for neurocognitive and psychosocial problems after Hodgkin lymphoma. Blood, 139(20), 3073–3086. https://doi.org/10.1182/blood.2021013167
Williams, AnnaLynn M., Sedigheh Mirzaei Salehabadi, Mengqi Xing, Nicholas S. Phillips, Matthew J. Ehrhardt, Rebecca Howell, Yutaka Yasui, et al. “Modifiable risk factors for neurocognitive and psychosocial problems after Hodgkin lymphoma.Blood 139, no. 20 (May 19, 2022): 3073–86. https://doi.org/10.1182/blood.2021013167.
Williams AM, Mirzaei Salehabadi S, Xing M, Phillips NS, Ehrhardt MJ, Howell R, et al. Modifiable risk factors for neurocognitive and psychosocial problems after Hodgkin lymphoma. Blood. 2022 May 19;139(20):3073–86.
Williams, AnnaLynn M., et al. “Modifiable risk factors for neurocognitive and psychosocial problems after Hodgkin lymphoma.Blood, vol. 139, no. 20, May 2022, pp. 3073–86. Pubmed, doi:10.1182/blood.2021013167.
Williams AM, Mirzaei Salehabadi S, Xing M, Phillips NS, Ehrhardt MJ, Howell R, Yasui Y, Oeffinger KC, Gibson T, Chow EJ, Leisenring W, Srivastava D, Hudson MM, Robison LL, Armstrong GT, Krull KR. Modifiable risk factors for neurocognitive and psychosocial problems after Hodgkin lymphoma. Blood. 2022 May 19;139(20):3073–3086.

Published In

Blood

DOI

EISSN

1528-0020

Publication Date

May 19, 2022

Volume

139

Issue

20

Start / End Page

3073 / 3086

Location

United States

Related Subject Headings

  • Young Adult
  • Survivors
  • Risk Factors
  • Quality of Life
  • Neoplasms
  • Male
  • Immunology
  • Humans
  • Hodgkin Disease
  • Female