Haematological cancer and quality of life: a systematic literature review

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Reference values for the EORTC QLQ‐C30 in patients with advanced stage Hodgkin lymphoma and in Hodgkin lymphoma survivors

To provide reference values for the European Organisation for Treatment and Research of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30) in advanced-stage Hodgkin Lymphoma (HL) patients and 5-year HL survivors. The QLQ-C30 is the most widely used cancer-specific questionnaire to assess Health-Related Quality of Life (HRQoL). The EORTC database was searched to identify HL RCTs in which patients' and survivors' HRQoL was assessed by the QLQ-C30. HRQoL mean scores were calculated and stratified by age and gender. Minimal important differences were used to assess the clinical relevance of the findings. Data from one RCT with HRQoL scores available at baseline (n = 343) and four RCTs with HRQoL scores available at follow-up (n = 1665) were analysed. Patients reported worse HRQoL scores than survivors across most functioning scales and symptoms' scales. These scores varied as a function of gender but not age. Survivors' HRQoL reports were comparable to the ones of the general population. These values provide an assessment framework for the comparison and interpretation of QLQ-C30 scores in advanced-stage HL. Our findings suggest that although HL patients' HRQoL scores are worse than the general population, HRQoL scores may normalize over long-term survival

Admitting adult critically ill patients with hematological malignancies to the ICU : a sisyphean task or work in progress?

The role of the intensive care unit in critically ill patients with a hematological malignancy has been a subject of discussion for years. An increase in survival rates of patients with a hematological malignancy has been observed over the last decades due to improvement in diagnostic methods, more effective treatments, and a better understanding of complications. Historically, the mortality of patients with a hematological malignancy requiring ICU admission was high, especially when the patient required mechanical ventilation or renal replacement therapy. Survival rates now differ considerably. Nonetheless, the ICU mortality rate in these patients has dropped impressively compared to the past, and 1-year survival rates up to 50% have been observed. The literature regarding quality of life after ICU admission is scarce and heterogeneous. Patients with a hematological malignancy may experience a decline in quality of life after ICU admission. However, some studies showed no difference between quality of life of patients admitted to the ICU compared to patients without ICU admission. Therefore, an ICU admission should be considered individually. Denial of ICU admission solely on the prejudice of quality of life is no longer justified. Thus, where the admission of patients with a hematological malignancy may have been a Sisyphean task in the past, recent outcome data of these patients suggest a work in progress