ASH 2023: Older NHL Patients Experience Improved Quality of Life Throughout Treatment

At the 2023 American Society of Hematology Conference, Dr. Patrick Connor Johnson, a lymphoma specialist from Massachusetts General Hospital, shared about a study he and his colleagues conducted between 2020 and 2023 looking at older patients with aggressive forms of NHL and their quality of life during and after receiving chemoimmunotherapy.

History of lymphoma treatment

Lymphomas are a group of blood cancers that can present in various forms, with aggressive lymphomas posing a particularly difficult challenge. Dr. Johnson emphasizes the urgency of effective treatment for these fast-growing cancers, which, if left untreated, can be fatal. While chemotherapy offers a potential cure, it comes with its own set of risks and side effects, especially for older patients.

In a society often focused on survival rates and medical interventions, Dr. Johnson introduces a different perspective—the importance of understanding and improving the quality of life for older adults undergoing lymphoma treatment. He mentions there is very little research done on patient-reported outcomes, such as the overall well-being and quality of life experienced during and after aggressive lymphoma treatment.

The study

Dr. Johnson’s team conducted a longitudinal prospective study (meaning a group of participants are followed over time) of 105 older adults with aggressive non-Hodgkin lymphoma (NHL). This group consisted of several subtypes of NHL. DLBCL (73.0%), DLBCL/high grade B-cell lymphoma with MYC and BCL2 translocations (12.4%), and mantle cell lymphoma (10.5%). 

The study specifically targeted patients aged 65 and older, acknowledging the unique challenges this demographic faces. With the oldest participant being an impressive 99 years old, the research aimed to provide insights into the experiences of older adults diagnosed with aggressive lymphomas. The study followed these individuals from the time of diagnosis through six months after the completion of therapy.

At multiple intervals during this journey, participants were asked to report on various aspects of their well-being. Dr. Johnson and his team explored the overall quality of life, anxiety, depression, and the physical symptom burden associated with cancer. The findings of the study present a surprising and encouraging narrative.

Contrary to common assumptions about the toll of chemotherapy on the elderly, the study reveals an improvement in the overall quality of life for this demographic. Astonishingly, this positive trend extends beyond the completion of treatment, persisting up to the six-month post-treatment mark. Rates of depression, anxiety, and physical symptom burden also decreased as patients progressed through therapy.

An additional analysis explored the concept of frailty—a measure of a patient's overall impairment from medical conditions or the lymphoma itself. Even among patients considered frail by medical metrics, improvements in quality of life were observed.

Improved quality of life

Dr. Johnson's takeaway from this study is one of encouragement. The results suggest that, despite the challenges posed by chemotherapy, improvements in quality of life are a reality for older adults undergoing these therapies. 

Looking ahead, Dr. Johnson expresses optimism about the future of lymphoma treatment. The focus now shifts to continuous improvement, striving to enhance patient-reported outcomes further. The goal is not only to better the experiences of those undergoing treatment, but also to identify individuals who may not have an improvement in their quality of life. This will enable the medical community to explore alternative treatments and interventions, ensuring that every patient receives the care best suited to their unique needs.

In a healthcare system often dominated by statistics and survival rates, Dr. Patrick Connor Johnson's work stands as an example of the importance of prioritizing the human experience in cancer care.