Health-related quality of life, depressive symptoms, and chronic fatigue in long-term survivors of Hodgkin lymphoma

High-dose chemotherapy with autologous stem cell transplantation (HDT-ASCT) is the preferred treatment option in relapsed or refractory Hodgkin lymphoma (HL). We analyzed the association between treatment intensity and health-related quality of life (HRQoL), depressive symptoms, and chronic fatigue (CF) in long-term survivors of HL (HLS), identified in two population-based national cross-sectional studies on late adverse effects. We included 375 HLS treated between 1987 and 2006, 264 with conventional therapy only, and 111 with HDT-ASCT. Despite similar differences to the matched general population, when controlling for other imbalances between the groups, use of HDT-ASCT was not associated with poorer outcome in multivariable analysis. However, work participation, family income, comorbidities, and lifestyle factors had stronger associations with aspects of HRQoL, depressive symptoms, and CF. Our data suggest that better rehabilitation to work participation and adequate income as well as follow-up for comorbidities may reduce differences in long-term outcome after treatment for HL.