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Correlates of common concerns in older cancer survivors of leukemia and lymphoma: results from the WHI LILAC study

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Abstract

Purpose

Older survivors of leukemia and lymphoma often experience long-term effects of chemotherapy. We described common concerns related to their cancer and treatment in older survivors of leukemia and non-Hodgkin lymphoma (NHL) and assessed correlates of these concerns.

Methods

We utilized data from the Women’s Health Initiative (WHI) Life and Longevity After Cancer (LILAC) study that recruited post-menopausal women aged 50–79. Participants diagnosed with leukemia and NHL were included (n = 420). They were asked about 14 areas of current concerns related to their cancer and treatment and to rate each from 0 (no concern) to 2 (major concern), with total scores ranging from 0 to 28. Linear regression was used to assess factors correlated with the concern score, and logistic regression for factors correlated with the three most common concerns.

Results

Mean age at assessment was 81 years (range 69–99); 72% reported at least one concern, and median concern score among these survivors was 3.5 (Q1–Q3 2–5). Factors significantly correlated with concern scores were sadness, pain, distress, higher prior symptom count, and loneliness (all p < 0.05). Significant factors correlated with common concerns were (1) fatigue/sleep: sadness/depression, distress, higher prior symptom count, greater loneliness, and worse physical functioning; (2) physical functioning/activity: older age, public insurance, higher body mass index, pain, worse QoL, and higher treatment-related comorbidities; (3) memory/concentration: prior chemotherapy or radiation, worse QoL, higher prior symptom count, and greater loneliness (all p < 0.05).

Conclusions and Implications for Cancer Survivors

Almost three-quarters of older survivors of leukemia and lymphoma reported at least one concern; a multifaceted intervention may be needed to address these concerns.

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Data availability

The datasets generated and/or analyzed during the current study are available through request from the WHI.

Data sharing

Access to raw data will require approval from the WHI Publication and Presentations Committee.

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Acknowledgements

The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, US Department of Health and Human Services through 75N92021D00001, 75N92021D00002, 75N92021D00003, 75N92021D00004, and 75N92021D00005. The WHI Life and Longevity after Cancer (LILAC) study is funded by UM1 CA173642 and a grant to Dr. Paskett from the Breast Cancer Research Foundation. Dr. Loh is supported by the National Cancer Institute (R00CA237744), Wilmot Research Fellowship Award, and Conquer Cancer American Society of Clinical Oncology Career Development Award.

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Authors and Affiliations

  1. Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, 601 Elmwood Avenue, Box 704, Rochester, NY, 14642, USA

    Kah Poh Loh

  2. Center for Biostatistics, The Ohio State University, Columbus, OH, USA

    Eric M. McLaughlin

  3. Division of Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA

    Jessica L. Krok-Schoen

  4. Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA

    Oreofe O. Odejide

  5. Center for Lymphoma, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA

    Oreofe O. Odejide

  6. Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA

    Areej El-Jawahri

  7. Harvard Medical School, Boston, MA, USA

    Areej El-Jawahri

  8. Department of Public Health Sciences, University of California Davis, Davis, CA, USA

    Lihong Qi

  9. Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA

    Aladdin H. Shadyab

  10. Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA

    Lisa G. Johnson

  11. Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA

    Electra D. Paskett

  12. Division of Cancer Prevention and Control, College of Medicine, The Ohio State University, Columbus, OH, USA

    Electra D. Paskett

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  1. Kah Poh Loh
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Contributions

KPL: conception and design, interpretation of data, manuscript writing, approval of final article;

EMM: analysis and interpretation of data, approval of final article.

JLK: conception and design, interpretation of data, manuscript writing, approval of final article;

OOO: conception and design, interpretation of data, manuscript writing, approval of final article;

AE: conception and design, interpretation of data, approval of final article;

LQ: interpretation of data, approval of final article;

AHS: interpretation of data, approval of final article;

LGJ: data collection, interpretation of data, approval of final article;

EDP: conception and design, data collection, interpretation of data, manuscript writing, approval of final article.

Corresponding author

Correspondence to Kah Poh Loh.

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Conflict of interest

Dr. Loh has served as a consultant to Pfizer and Seattle Genetics and has received honoraria from Pfizer. Dr. Paskett has received grant funding from the Merck Foundation and Pfizer. All other authors report no conflicts of interest.

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Loh, K.P., McLaughlin, E.M., Krok-Schoen, J.L. et al. Correlates of common concerns in older cancer survivors of leukemia and lymphoma: results from the WHI LILAC study. J Cancer Surviv 17, 769–780 (2023). https://doi.org/10.1007/s11764-022-01249-1

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