Influence of Sociodemographic Determinants on the Hodgkin Lymphoma Baseline Characteristics in Long Survivors Patients Enrolled in the Prospective Phase 3 Trial AHL2011
Introduction: Whereas numerous studies on several cancers describe the link between social conditions and disease severity, little is known about the social and demographic characteristics of Hodgkin lymphoma (HL) patients. At diagnosis, 10–15% of the patients in the advanced stages have a well-know...
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| Format: | Article |
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MDPI AG
2022-12-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/1/53 |
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| author | Steeve Chevreux Sandra de Barros Camille Laurent Amandine Durand Cyrille Delpierre Philippine Robert Clémentine Joubert Samuel Griolet Salim Kanoun Jean-Noël Bastie René-Olivier Casasnovas Cédric Rossi |
| author_facet | Steeve Chevreux Sandra de Barros Camille Laurent Amandine Durand Cyrille Delpierre Philippine Robert Clémentine Joubert Samuel Griolet Salim Kanoun Jean-Noël Bastie René-Olivier Casasnovas Cédric Rossi |
| author_sort | Steeve Chevreux |
| collection | DOAJ |
| description | Introduction: Whereas numerous studies on several cancers describe the link between social conditions and disease severity, little is known about the social and demographic characteristics of Hodgkin lymphoma (HL) patients. At diagnosis, 10–15% of the patients in the advanced stages have a well-known poor outcome owing to their chemoresistance, but the determinants of the more advanced stages remain elusive. The objective of the present study was to decipher the potential impact of social disparities on the disease features at diagnosis and analyze how the sociodemographic patient features could impact the HL outcome of patients with advanced-stage HL enrolled in the AHL2011 trial. Methods: This ancillary study was conducted on a cohort of patients from French centers that had recruited more than five patients in the phase III AHL2011 study (NCT0135874). Patients had to be alive at the time of the ancillary study and had to have given their consent to answer the questionnaire. Pre-treatment data (age, gender, stage, B symptoms, IPS), the treatment received, the responses to PET-CT, and the presence of serious adverse events (serious adverse events—SAEs) were all extracted from the AHL2011 trial database. Sociodemographic data—marital status, living area, level of education, socio-professional category, and professional situation—were extracted from the questionnaires. The population density at the point of diagnosis was determined based on ZIP Code, and the distance from the reference medical center was then calculated by the road network. Baseline PET acquisition was performed before any treatment. PET images at baseline were centrally reviewed. The total metabolic tumor volume (TMTV) at the baseline was calculated using a 41% SUVmax cutoff for each lesion. Progression-free survival was defined as the time from randomization to the first progression, relapse, or death from any cause or the last follow-up. The data cutoff for the analyses presented here was 31 October 2017. The progression-free survival was analyzed on an intention-to-treat basis. Results: Among the 823 patients enrolled in the AHL2011 study, the questionnaire was sent to 394 patients, of whom 232 (58.9%) responded. At the time of HL diagnosis, 61.9% (N = 143) of patients declared that they were not socially isolated, 38.1% (N = 88) that they were single, 163 (71.2%) had a professional activity, and 66 (28.8%) were inactive owing to unemployment, retirement, or sick leave. Of the patients, 31.1% (N = 71) lived in a rural region, compared to 68.9% (N = 157) that lived in an urban region. The residence ZIP Code at the time of HL diagnosis was available for 163 (70%). Sociodemographic characteristics did not influence the presence of usual prognostic factors (ECOG, B symptoms, bulky mass, IPS) except for professional activity, which was associated with more frequent low IPS (0–2) (79 (48.5%) active versus 20 (30.3%) inactive patients; <i>p</i> = 0.012). Likewise, no correlation was observed between TMTV and sociodemographic characteristics. However, the TMTV quartile distribution was different according to the living area, with the two upper quartiles being enriched with patients living in a rural area (<i>p</i> = 0.008). Moreover, a negative correlation between the average number of the living area’s inhabitants and TMTV (R Pearson = −0.29, <i>p</i> = 0.0004) was observed. Conclusion: This study focused on sociodemographic parameters in advanced-stage HL patients and shows that professional activity is associated with more favorable disease features (low IPS), while patients living in rural or low-populated areas are more likely to have an unfavorable HL presentation with a high tumor burden (high TMTV). These data suggest that some patient sociodemographic characteristics might impact either access to medical care or environmental exposure, leading to a higher frequency of unfavorable presentations. Further prospective sociodemographic studies are necessary to confirm these preliminary results. |
| first_indexed | 2024-03-11T10:06:51Z |
| format | Article |
| id | doaj.art-6ee8c0dc8a1b4b2ba5da0aa927ff995a |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T10:06:51Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-6ee8c0dc8a1b4b2ba5da0aa927ff995a2023-11-16T15:01:00ZengMDPI AGCancers2072-66942022-12-011515310.3390/cancers15010053Influence of Sociodemographic Determinants on the Hodgkin Lymphoma Baseline Characteristics in Long Survivors Patients Enrolled in the Prospective Phase 3 Trial AHL2011Steeve Chevreux0Sandra de Barros1Camille Laurent2Amandine Durand3Cyrille Delpierre4Philippine Robert5Clémentine Joubert6Samuel Griolet7Salim Kanoun8Jean-Noël Bastie9René-Olivier Casasnovas10Cédric Rossi11Department of Hematology, Dijon-Bourgogne University Hospital, 21000 Dijon, FranceDepartment of Hematology, University Institute of Cancer Toulouse-Oncopole, 31100 Toulouse, FranceDepartment of Pathology, University Institute du Cancer, Toulouse University Hospital, 31300 Toulouse, FranceDepartment of Hematology, Dijon-Bourgogne University Hospital, 21000 Dijon, FranceDepartment of Hematology, University Institute of Cancer Toulouse-Oncopole, 31100 Toulouse, FranceDepartment of Hematology, Dijon-Bourgogne University Hospital, 21000 Dijon, FranceLymphoma Academic Research Organisation, CHU Lyon-Sud, 69495 Lyon, FranceLymphoma Academic Research Organisation, CHU Lyon-Sud, 69495 Lyon, FranceNuclear Medicine Unit, Institut Universitaire du Cancer Toulouse-Oncopole, 31100 Toulouse, FranceDepartment of Hematology, Dijon-Bourgogne University Hospital, 21000 Dijon, FranceDepartment of Hematology, Dijon-Bourgogne University Hospital, 21000 Dijon, FranceDepartment of Hematology, Dijon-Bourgogne University Hospital, 21000 Dijon, FranceIntroduction: Whereas numerous studies on several cancers describe the link between social conditions and disease severity, little is known about the social and demographic characteristics of Hodgkin lymphoma (HL) patients. At diagnosis, 10–15% of the patients in the advanced stages have a well-known poor outcome owing to their chemoresistance, but the determinants of the more advanced stages remain elusive. The objective of the present study was to decipher the potential impact of social disparities on the disease features at diagnosis and analyze how the sociodemographic patient features could impact the HL outcome of patients with advanced-stage HL enrolled in the AHL2011 trial. Methods: This ancillary study was conducted on a cohort of patients from French centers that had recruited more than five patients in the phase III AHL2011 study (NCT0135874). Patients had to be alive at the time of the ancillary study and had to have given their consent to answer the questionnaire. Pre-treatment data (age, gender, stage, B symptoms, IPS), the treatment received, the responses to PET-CT, and the presence of serious adverse events (serious adverse events—SAEs) were all extracted from the AHL2011 trial database. Sociodemographic data—marital status, living area, level of education, socio-professional category, and professional situation—were extracted from the questionnaires. The population density at the point of diagnosis was determined based on ZIP Code, and the distance from the reference medical center was then calculated by the road network. Baseline PET acquisition was performed before any treatment. PET images at baseline were centrally reviewed. The total metabolic tumor volume (TMTV) at the baseline was calculated using a 41% SUVmax cutoff for each lesion. Progression-free survival was defined as the time from randomization to the first progression, relapse, or death from any cause or the last follow-up. The data cutoff for the analyses presented here was 31 October 2017. The progression-free survival was analyzed on an intention-to-treat basis. Results: Among the 823 patients enrolled in the AHL2011 study, the questionnaire was sent to 394 patients, of whom 232 (58.9%) responded. At the time of HL diagnosis, 61.9% (N = 143) of patients declared that they were not socially isolated, 38.1% (N = 88) that they were single, 163 (71.2%) had a professional activity, and 66 (28.8%) were inactive owing to unemployment, retirement, or sick leave. Of the patients, 31.1% (N = 71) lived in a rural region, compared to 68.9% (N = 157) that lived in an urban region. The residence ZIP Code at the time of HL diagnosis was available for 163 (70%). Sociodemographic characteristics did not influence the presence of usual prognostic factors (ECOG, B symptoms, bulky mass, IPS) except for professional activity, which was associated with more frequent low IPS (0–2) (79 (48.5%) active versus 20 (30.3%) inactive patients; <i>p</i> = 0.012). Likewise, no correlation was observed between TMTV and sociodemographic characteristics. However, the TMTV quartile distribution was different according to the living area, with the two upper quartiles being enriched with patients living in a rural area (<i>p</i> = 0.008). Moreover, a negative correlation between the average number of the living area’s inhabitants and TMTV (R Pearson = −0.29, <i>p</i> = 0.0004) was observed. Conclusion: This study focused on sociodemographic parameters in advanced-stage HL patients and shows that professional activity is associated with more favorable disease features (low IPS), while patients living in rural or low-populated areas are more likely to have an unfavorable HL presentation with a high tumor burden (high TMTV). These data suggest that some patient sociodemographic characteristics might impact either access to medical care or environmental exposure, leading to a higher frequency of unfavorable presentations. Further prospective sociodemographic studies are necessary to confirm these preliminary results.https://www.mdpi.com/2072-6694/15/1/53Hodgkin lymphomasocialPETprognosis |
| spellingShingle | Steeve Chevreux Sandra de Barros Camille Laurent Amandine Durand Cyrille Delpierre Philippine Robert Clémentine Joubert Samuel Griolet Salim Kanoun Jean-Noël Bastie René-Olivier Casasnovas Cédric Rossi Influence of Sociodemographic Determinants on the Hodgkin Lymphoma Baseline Characteristics in Long Survivors Patients Enrolled in the Prospective Phase 3 Trial AHL2011 Cancers Hodgkin lymphoma social PET prognosis |
| title | Influence of Sociodemographic Determinants on the Hodgkin Lymphoma Baseline Characteristics in Long Survivors Patients Enrolled in the Prospective Phase 3 Trial AHL2011 |
| title_full | Influence of Sociodemographic Determinants on the Hodgkin Lymphoma Baseline Characteristics in Long Survivors Patients Enrolled in the Prospective Phase 3 Trial AHL2011 |
| title_fullStr | Influence of Sociodemographic Determinants on the Hodgkin Lymphoma Baseline Characteristics in Long Survivors Patients Enrolled in the Prospective Phase 3 Trial AHL2011 |
| title_full_unstemmed | Influence of Sociodemographic Determinants on the Hodgkin Lymphoma Baseline Characteristics in Long Survivors Patients Enrolled in the Prospective Phase 3 Trial AHL2011 |
| title_short | Influence of Sociodemographic Determinants on the Hodgkin Lymphoma Baseline Characteristics in Long Survivors Patients Enrolled in the Prospective Phase 3 Trial AHL2011 |
| title_sort | influence of sociodemographic determinants on the hodgkin lymphoma baseline characteristics in long survivors patients enrolled in the prospective phase 3 trial ahl2011 |
| topic | Hodgkin lymphoma social PET prognosis |
| url | https://www.mdpi.com/2072-6694/15/1/53 |
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