Abstract P095

Chemotherapy-induced peripheral neuropathy and quality of life among Hodgkin lymphoma survivors treated at an older age - A national cross-sectional study

Background: Chemotherapy induced peripheral neuropathy (CIPN) is a potentially debilitating long-term side effect of Hodgkin lymphoma (HL) treatment that can impact health and lead to a reduced quality of life. In this national cross-sectional study, we evaluated the prevalence and severity of CIPN among older tumor-free HL survivors (HLSs) at a median of 8 years after diagnosis.

Methods: Two hundred and ninety HLSs aged >60 years at diagnosis were invited to participate and 193 (67%) completed a 95-item questionnaire including patient-reported outcome measures assessing physical and mental health related quality of life (HRQoL), fatigue, activities of daily living and anxiety/depression. CIPN was assessed via the validated European organisation for research and treatment of cancer, quality of life questionnaire for chemotherapy-induced neuropathy 20 (EORTC QLQ-CIPN20). Findings were compared to a Dutch age– and sex-matched control population. Details regarding treatment were extracted from patient records.

Results: Of the consenting participants 185 (96%) had received at least one treatment regimen containing a potentially neurotoxic compound. At a median of 8 years after diagnosis, HLSs reported a significantly higher neuropathy sum score (NSS) than controls (20.8 versus 7.4, p<0.001), irrespective of the neurotoxic agent received (vincristine, vinblastine, brentuximab vedotin or combinations thereof). Dose reductions due to treatment-emergent CIPN was most commonly done in patients receiving vincristine. Development of CIPN CTCAE grade ≥1 during treatment or CIPNCTCAE ≥2 one year or more after treatment predicted a higher NSS at time of survey. Multivariable regression analysis showed a significant association between the total doses of neurotoxic drugs received and NSS, most clearly related to the dose of vincristine. Also, a higher total comorbidity score at survey was positively correlated with NSS. Survivors with higher CIPN symptom burden were significantly more fatigued, had higher levels of anxiety and depression and lower HRQoL at survey, but showed similar levels of independence in functions of daily life.

Conclusion: Older HLSs report dose-dependent higher CIPN symptom burden compared to controls at a median of 8 years after treatment. Neuropathy symptom burden was associated with worse fatigue, anxiety, depression and HRQoL, highlighting the long-term impact of treatment-related neuropathy on survivorship outcomes.