Quality of life at diagnosis predicts overall survival in patients with aggressive lymphoma

Carrie A Thompson, Kathleen J Yost, Matthew J. Maurer, Cristine Allmer, Umar Farooq, Thomas Matthew Habermann, David J. Inwards, William R. Macon, Brian K. Link, Allison C. Rosenthal, James R Cerhan

Research output: Contribution to journalArticle

1 Scopus citations


Our aim was to evaluate whether quality of life (QOL) scores at diagnosis predict survival among patients with aggressive lymphoma. Newly diagnosed lymphoma patients were prospectively enrolled within 9 months of diagnosis in the University of Iowa/Mayo Clinic SPORE and systematically followed for event-free and overall survival (OS). QOL was measured with the Functional Assessment of Cancer Treatment-General (FACT-G), which measures 4 domains: physical, social/family, emotional, and functional well-being (WB); a single item Linear Analogue Self-Assessment (LASA) measuring overall QOL; and a spiritual WB LASA. From 9/2002 to 12/2009, 701 patients with aggressive lymphoma who completed baseline QOL questionnaires were enrolled. At a median follow-up of 71 months (range 6-128), 316 patients (45%) had an event and 228 patients (33%) died. All baseline QOL measures but emotional WB were significantly associated with OS (all P < 0.04); of which all but LASA spiritual remained significant after adjusting for IPI and NHL subtype. The strongest associations were with total FACT-G (adjusted HR = 0.86, 95% CI: 0.79-0.94, P = 0.00062) and functional WB (adjusted HR = 0.88, 95% CI: 0.83-0.93, P <.0001). QOL LASA was associated with OS (adjusted HR = 0.92, 95% CI: 0.87-0.97, P = 0.0041). Patients with clinically deficient QOL (overall QOL ≤50) had a median OS of 92 months compared with 121 months for patients with QOL >50 (P = 0.0004). In this large sample of patients with aggressive lymphoma, we found that baseline QOL is independently predictive of OS. QOL should be assessed as a prognostic factor in patients with aggressive lymphoma.

Original languageEnglish (US)
Pages (from-to)749-756
Number of pages8
JournalHematological Oncology
Issue number5
StatePublished - Dec 1 2018



  • lymphoma
  • prognosis
  • quality of life
  • surveys and questionnaires
  • survival

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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