title: Health-related quality of life in Hodgkin lymphoma: a systematic review.
abstract: OBJECTIVE
  Hodgkin Lymphoma (HL) is highly curable with well-established treatment regimens; however, the impact on patient's health-related quality of life (HRQL) from diagnosis through survivorship is unclear. This systematic review aimed to describe the available literature on HRQL in HL, assess the quality of these studies, identify gaps in the literature and recommend further areas of research.
  
  
  METHODS
  Following PRISMA guidelines, we performed a systematic review to include studies assessing the HRQL in HL patients. Articles identified through database searches were screened and data extracted. Quality was evaluated using a 6-point scale, adapted from published HRQL systematic reviews.
  
  
  RESULTS
  Sixty five articles published between 1986 and 2015 met inclusion criteria. These included 53 (82 %) cross-sectional studies; 12 (18 %) longitudinal studies, including three embedded in randomized trials; and three additional longitudinal studies that began assessment at diagnosis. Study sample sizes of HL patients varied considerably with only five (42 %) longitudinal studies including more than 50 patients. Multidimensional HRQL was assessed in 45 studies, single HRQL domains in 22 studies, and symptoms, including fatigue, in 28 studies.
  
  
  CONCLUSIONS
  The majority of studies employed a cross-sectional design, enrolling HL survivors at least 10 years after the completion of therapy. Emphasis on HRQL following therapy may inform initial treatment decisions and long-term survivorship goals. We recommend that future research include prospective, longitudinal randomized designs across both treatment and time.
authors.affiliation: Tufts Cancer Center, Tufts Medical Center, 800 Washington Street, #245, Boston, MA, 02111, USA. nlinendoll@tuftsmedicalcenter.org.|Tufts University School of Medicine, 145 Harrison Avenue, Boston, MA, 02111, USA. nlinendoll@tuftsmedicalcenter.org.
authors.forename: Nadine
authors.initials: N
authors.lastname: Linendoll
authors.affiliation: Institute for Clinical Research and Health Policy, Tufts Medical Center, 800 Washington Street, #345, Boston, MA, 02111, USA.
authors.forename: Tully
authors.initials: T
authors.lastname: Saunders
authors.affiliation: Institute for Clinical Research and Health Policy, Tufts Medical Center, 800 Washington Street, #345, Boston, MA, 02111, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Burns
authors.affiliation: Tufts University School of Medicine, 145 Harrison Avenue, Boston, MA, 02111, USA.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Nyce
authors.affiliation: Advocate Lutheran General Hospital, 1775 Dempster St, Park Ridge, IL, 60068, USA.
authors.forename: Kristen B
authors.initials: KB
authors.lastname: Wendell
authors.affiliation: Tufts Cancer Center, Tufts Medical Center, 800 Washington Street, #245, Boston, MA, 02111, USA.|Tufts University School of Medicine, 145 Harrison Avenue, Boston, MA, 02111, USA.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Evens
authors.affiliation: Tufts Cancer Center, Tufts Medical Center, 800 Washington Street, #245, Boston, MA, 02111, USA.|Institute for Clinical Research and Health Policy, Tufts Medical Center, 800 Washington Street, #345, Boston, MA, 02111, USA.|Tufts University School of Medicine, 145 Harrison Avenue, Boston, MA, 02111, USA.
authors.forename: Susan K
authors.initials: SK
authors.lastname: Parsons
mesh_terms: D000223:Adaptation, Psychological; D003430:Cross-Sectional Studies; D006689:Hodgkin Disease / Q000523:psychology*; D006801:Humans; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D017741:Survivors / Q000523:psychology
keywords: Hodgkin lymphoma; Quality of life; Survivorship; Systematic review