AbstractObjectiveTo define the prevalence of neuromuscular, musculoskeletal, pain, visceral, oncologic and other late effects impacting function and quality of life in Hodgkin lymphoma(HL) survivors presenting to an outpatient cancer rehabilitation clinic.DesignA retrospective cohort analysis.SettingOutpatient cancer rehabilitation clinic.ParticipantsOne hundred consecutive HL survivors.InterventionsNone.Main Outcome MeasuresThe prevalence of neuromuscular, musculoskeletal, pain, visceral, oncologic and other late effects contributing to functional impairment and disability in HL survivors.ResultsAmong the 100 HL survivors, 43% received chemotherapy, 94% radiation therapy, and 38% a combination of chemotherapy and radiation for initial treatment. Nearly all HL survivors were diagnosed with myelopathy (83%), radiculo-plexopathy (93%), mononeuropathy (95%) and localized myopathy (93%). Musculoskeletal sequelae were extremely common and included dropped head syndrome (83%), cervicalgia (79%), shoulder girdle dysfunction (73%), and dysphagia (42%). Visceral disorders were also common and included cardiovascular (70%), pulmonary (44%), endocrine (63%), gastrointestinal (29%), and genitourinary (11%) dysfunction. Lymphedema affected 21% of survivors and 30% had a history of a secondary malignancy. Pain (71%), fatigue (45%), and dyspnea (43%) were major function-limiting impairments. Nearly all (95%) of survivors were referred to at least one therapy discipline including physical therapy, occupational therapy, speech and language pathology and/or lymphedema therapy.ConclusionNeuromuscular, musculoskeletal, pain, visceral, oncologic and other late effectsare extremely common in HL survivors seeking physiatric evaluation. Multiple function-limiting disorders can co-exist in HL survivors with the potential to severely compromise function and quality of life. Safe and effective rehabilitation may depend on the physiatrist’s ability to identify, evaluate and manage the multitude of complex and often interrelated functional late effects seen in HL survivors.
Influence of new late effects on quality of life over time in Hodgkin lymphoma Survivors: a longitudinal survey study
