Contributions
Abstract: PB1550
Type: Publication Only
Session title: Hodgkin lymphoma - Clinical
Background
In the current years it is estimated that cancer survivors are more than 16 million and it is predicted to reach 22 million by 2030.The prevalence of long-term lymphoma survivors is steadily increasing, and includes mainly histotypes for which biological knowledge and treatments obtained better results. Up today there is a paucity of data on late toxicities affecting lymphoma survivors, thus we still need more data from literature to follow late sequelae of these patients and to set up an organized and evidence based follow-up strategy.
Aims
Researchers belonging to the Fondazione Italiana Linfomi drawn a series of systematic reviews with the aim to :i) evaluate available data and develop homogeneous indications for lymphoma survivors’ monitoring using a systematic approach; ii) find a balance between the unmet medical need and the sustainability of healthcare system.
Methods
The research work was carried out by a multi-disciplinary team of 16 researchers of the Fondazione Italiana Linfomi under the methodological supervision of 3 Researchers of the Istituto di Ricerche Farmacologiche “Mario Negri”, in Milan. The systematic reviews focused on six topics: cardiotoxicity, secondary cancers, endocrine-metabolic sequelae, fertility and neurological/ cognitive toxicities, healthy lifestyles. The following specific questions were analyzed, considering the population of classical Hodgkin lymphoma (cHL) and Diffuse large B-cell lymphoma (DLBCL) survivors treated at adult age (≥ 18 years old): i) incidence of the long-term toxicity; ii) comparison with more recent therapies (e.i. modern radiation therapy); iii) best monitoringof long-term sequelae. The search was conducted on 3 bibliographic databases (PubMed, Embase and the Cochrane Library) with also hand searching up to December, 2020. Selection process and data extraction were conducted according to the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines.
Results
Six independent systematic reviews were conducted according to the topics of research. A global number of 170 full text papers resulted eligible for data extraction and were included in the final sample. They concerned: cardiotoxicity (n=22), secondary cancers (n=21), endocrine-metabolic sequelae (n=9), fertility (n=46), neurologic and cognitive toxicity (n=62), healthy lifestyles (n=10). The incidence for cardiovascular disease, endocrine-metabolic sequelae, secondary cancers, neurological and anxiety and depression, infertility were calculated and related to risk factors. The optimal detection and monitoring was found out for: i) early left ventricular ejection fraction dysfunction, coronary artery disease, valvular heart disease; ii) secondary acute myeloid leukemias/ myelodisplastic syndromes and solid tumors; iii) metabolic syndrome, thyroid, gonadal, and mineral bone disorders; iv) peripheral neuropathy, fatigue, cognitive impairment, anxiety and depression. Fertility preservation and correction of unhealthy lifestyles were also examined. The possible use of Survivorship Care Plans was introduced.
Conclusion
The final documents could be a reasonable bridge from evidence to decision in order to improve the clinical practice and customize the general follow-up approach of cHL and DLBCL survivors. Data emerged will suggest also direction of future research.
Keyword(s): Follow-up, Lymphoma, Survival, Toxicity
Abstract: PB1550
Type: Publication Only
Session title: Hodgkin lymphoma - Clinical
Background
In the current years it is estimated that cancer survivors are more than 16 million and it is predicted to reach 22 million by 2030.The prevalence of long-term lymphoma survivors is steadily increasing, and includes mainly histotypes for which biological knowledge and treatments obtained better results. Up today there is a paucity of data on late toxicities affecting lymphoma survivors, thus we still need more data from literature to follow late sequelae of these patients and to set up an organized and evidence based follow-up strategy.
Aims
Researchers belonging to the Fondazione Italiana Linfomi drawn a series of systematic reviews with the aim to :i) evaluate available data and develop homogeneous indications for lymphoma survivors’ monitoring using a systematic approach; ii) find a balance between the unmet medical need and the sustainability of healthcare system.
Methods
The research work was carried out by a multi-disciplinary team of 16 researchers of the Fondazione Italiana Linfomi under the methodological supervision of 3 Researchers of the Istituto di Ricerche Farmacologiche “Mario Negri”, in Milan. The systematic reviews focused on six topics: cardiotoxicity, secondary cancers, endocrine-metabolic sequelae, fertility and neurological/ cognitive toxicities, healthy lifestyles. The following specific questions were analyzed, considering the population of classical Hodgkin lymphoma (cHL) and Diffuse large B-cell lymphoma (DLBCL) survivors treated at adult age (≥ 18 years old): i) incidence of the long-term toxicity; ii) comparison with more recent therapies (e.i. modern radiation therapy); iii) best monitoringof long-term sequelae. The search was conducted on 3 bibliographic databases (PubMed, Embase and the Cochrane Library) with also hand searching up to December, 2020. Selection process and data extraction were conducted according to the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines.
Results
Six independent systematic reviews were conducted according to the topics of research. A global number of 170 full text papers resulted eligible for data extraction and were included in the final sample. They concerned: cardiotoxicity (n=22), secondary cancers (n=21), endocrine-metabolic sequelae (n=9), fertility (n=46), neurologic and cognitive toxicity (n=62), healthy lifestyles (n=10). The incidence for cardiovascular disease, endocrine-metabolic sequelae, secondary cancers, neurological and anxiety and depression, infertility were calculated and related to risk factors. The optimal detection and monitoring was found out for: i) early left ventricular ejection fraction dysfunction, coronary artery disease, valvular heart disease; ii) secondary acute myeloid leukemias/ myelodisplastic syndromes and solid tumors; iii) metabolic syndrome, thyroid, gonadal, and mineral bone disorders; iv) peripheral neuropathy, fatigue, cognitive impairment, anxiety and depression. Fertility preservation and correction of unhealthy lifestyles were also examined. The possible use of Survivorship Care Plans was introduced.
Conclusion
The final documents could be a reasonable bridge from evidence to decision in order to improve the clinical practice and customize the general follow-up approach of cHL and DLBCL survivors. Data emerged will suggest also direction of future research.
Keyword(s): Follow-up, Lymphoma, Survival, Toxicity