Heterogeneity of New Hodgkin’s Disease Patients in Terms of Their Quality of Life.

Background: It is quite obvious that population of new Hodgkin’s disease (HD) patients is heterogeneous in terms of clinical characteristics. Therefore stratification of patients is necessary to select appropriate treatment regimen. It was shown that new lymphoma patient population is heterogeneous in terms of base-line QoL (Novik A et al, 2003).

The aim of the study was to identify if new HD patients are heterogeneous in terms of QoL and to stratify patients using QoL parameters.

Patients and methods: 114 new HD patients (stage IIB-IV, mean age 30.2 (SD 13.5), males/females - 55/59) were enrolled in the study. Patients filled in EORTC QLQ-C30 at baseline. The method of integral profiles (MIP) was used to calculate integral QoL index (IQL), the coefficient of QoL deformation (CQLD) and the index of symptom severity (ISS). The above indexes were used for stratification by the cluster analysis (Ward method, percent of cases correctly classified - 98.25%). Discriminant analysis was performed for stratification testing.

Results: Three groups of HD patients were identified after stratification. IQL, CQLD and ISS were as follows: subgroup 1 (n=5, mean age 40.8 (22.9), male/female 1/4) − 0.04, 1.7, 0.17; subgroup 2 (n=47, mean age 34.3 (14.5), male/female 23/24) − 0.35, 0.62, 0.09; subgroup 3 (n=62; mean age 26.0 (9.7); male/female 31/31) − 0.74, 0.24, 0.01. Group 1 has the worst QoL and is characterized by low IQL, pronounced symptoms and high deformation of QoL profile. Group 3 has the best QoL with high IQL, weak symptoms and low deformation of QoL profile. Group 2 has intermediate values of above parameters. Differences between groups were significant (p<0.05) by ANOVA.

Conclusion: The method of integral profiles to obtain the integral QoL index and the coefficient of QoL deformation in HD patients is proposed. Stratification of new HD patients by cluster analysis resulted in three patient subgroups according to their QoL data. Identification of subgroups of HD patients on the basis of their QoL has a good potential for better stratification of new HD patients and in doing so might be used for improvement of the intervention strategies.