HL-416: Late Toxicities and Long-Term Monitoring in Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma Survivors: A Series of Systematic Reviews of the Fondazione Italiana Linfomi

• Published in: Clinical lymphoma, myeloma and leukemia Vol. 21; pp. S374 - S375
• Main Authors: Minoia, Carla, Gerardi, Chiara, Allocati, Eleonora, De Sanctis, Vitaliana, Franceschetti, Silvia, Viviani, Simonetta, Annunziata, Maria Antonietta, Bari, Alessia, Skrypeta, Tetiana, Oliva, Stefano, Puzzovivo, Agata, Di Molfetta, Sergio, Caccavari, Valentina, Di Russo, Anna, Loseto, Giacomo, Daniele, Antonella, Nassi, Luca, Gini, Guido, Guarini, Attilio
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.09.2021
• Subjects: late toxicity; lymphoma; prevention; survivorship; systematic review; survivorship; HL; systematic review; prevention; lymphoma; late toxicity
• ISSN: 2152-2650; 2152-2669
• DOI: 10.1016/S2152-2650(21)01855-3

It is estimated that cancer survivors number more than 16 million in the USA and 12 million in Europe, and rapid population growth is predicted. We still need more information to set up an evidence-based follow-up and preventive strategy for lymphoma survivors. i) Evaluate the incidence of long-term sequelae due to treatments for classical Hodgkin lymphoma (cHL) and diffuse large B-cell lymphoma (DLBCL). ii) Find evidence for early detection and monitoring. iii) Find evidence for tertiary prevention and education on healthy lifestyles. Six different systematic reviews were planned. The selection process and data extraction were conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The research work was carried out by a multidisciplinary team of 16 FIL Researchers under the methodological supervision of the Istituto di Ricerche Farmacologiche Mario Negri (Milan). Long-term cHL and DLBCL survivors treated at ≥18 years old were selected as the patient population. MEDLINE (via PubMed), the Cochrane Library, and EMBASE were systematically searched from January 1990 to December 2020, with no language or publication type restrictions. Search terms included extensive controlled vocabulary (MeSH and EMTREE) and free-text keywords, combining the conditions, interventions, and outcomes of interest. The systematic reviews focused on 6 topics: cardiotoxicity, secondary cancers, endocrine-metabolic sequelae, fertility, neurological toxicities, and healthy lifestyles. The following questions were analyzed: incidence of long-term toxicity; comparison with recent therapies (i.e., modern radiation therapy); best monitoring. 170 full-text papers were included in the final analysis for the 6 systematic reviews. They concerned cardiotoxicity (n=22), secondary cancers (n=21), endocrine-metabolic sequelae (n=9), fertility (n=46), neurologic and cognitive toxicity (n=62), and healthy lifestyles (n=10). The optimal monitoring was found for: i) early left ventricular ejection fraction dysfunction, coronary artery disease, valvular heart disease; ii) secondary acute myeloid leukemias/myelodysplastic syndromes and solid tumors; iii) metabolic syndrome, thyroid, gonadal, and mineral bone disorders; iv) fatigue, cognitive impairment, anxiety, and depression. Fertility preservation and correction of unhealthy lifestyles were also examined. 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.