Interventions Improve Psychologic Distress Among Patients With Indolent Non-Hodgkin Lymphoma 

Patients with indolent non-Hodgkin lymphoma (iNHL) demonstrated anxiety and post-traumatic stress disorder (PTSD), with nearly half of patients using denial as a coping strategy, according to the results of a cross-sectional study. The results of the study were published in The Oncologist.

Interventions directed at addressing the feeling of uncertainty and promoting positive emotional coping strategies improved psychological distress.

“Oncology clinician awareness and recognition of prognosis-related concerns at diagnosis of indolent lymphoma are important,” the authors wrote in their report, also explaining “supportive care interventions to promote higher emotional coping with prognosis have the potential to reduce psychological distress in this patient population.”

The study evaluated 48 patients who were newly diagnosed with iNHL at a single academic center. Questionnaires were administered to assess quality of life (QOL), anxiety and depression symptoms, coping, and perception of prognosis.

The mean age of the patients was 66.9, 60.4% were female, and 85.4% were White, 8.3% were Asian, and patients who were African American, American Indian, and Middle Eastern each constituted 2.1% of the patient population. The majority of patients were married or cohabitating. 

The most common lymphoma was chronic lymphocytic leukemia/small cell leukemia, followed by follicular lymphoma and marginal zone lymphoma. The majority of patients were under active surveillance at 64.6%, 12.5% were on treatment with curative intent, and 22.9% were on palliative treatment.

Any clinically significant symptom of psychological distress was reported by 33.3% of patients, including 27.1% with anxiety and 14.6% with symptoms of PTSD. Prognosis was indicated as a worry for 45.8% of patients and a topic of perseverating for 31.2%.  

The perception of the diagnosis as a threat was most commonly related to an indefinite timeline, concern, and loss of personal control. The most common coping strategy was acceptance, which was used by 56.2% of patients, followed by 47.9% who sought emotional support and 47.9% who practiced denial. 

The use of emotional coping of prognosis was significantly associated with fewer symptoms of anxiety (B=-0.6; P <.001), depression (-B, -0.3;  P =.005), and PTSD (B, -1.3; P <.001). QOL was also improved with emotional coping (B, 1.7; P <.001).

There were 64.6% of patients who believed their disease was curable, despite 66.7% reporting that their oncologist told them it was incurable.

The results of this study suggest that “interventions to address prognostic uncertainty and to promote positive emotional coping with prognosis in patients with iNHL are an unmet need and have the potential to ameliorate psychological distress and improve QOL in this patient population,” the study authors concluded.

Disclosures: Some of the study authors declared affiliations with biotech, pharmaceutical, or device companies. Please see the original reference for a full list of disclosures.

Reference
Newcomb RA, Johnson PC, Yang D, et al. Coping and perception of prognosis in patients with indolent non-Hodgkin’s lymphoma. Oncologist. Published online November 3, 2023. doi:10.1093/oncolo/oyad295

This article originally appeared on Hematology Advisor