Multidisciplinary Management of Adolescent and Young Adult Patients with Hodgkin Lymphoma

A 12-week WeChat education, relaxing, and care program relieves anxiety, depression, insomnia, and posttraumatic stress disorder in parents of childhood lymphoma patients

OBJECTIVES

In our previous study, we conducted a 6-month WeChat education and care program for parents of pediatric acute lymphoblastic leukemia patients, which was effectively alleviated anxiety, depression, and insomnia. This study implemented a 12-week WeChat education, relaxing, and care program (WERC) to investigate its effect on psychological disorders and insomnia in parents of childhood lymphoma patients.

METHODS

Totally, 112 parents of 56 childhood lymphoma patients were randomized at a 1:1 ratio into WERC (N = 56) or normal care (NC) (N = 56) groups to receive corresponding 12-week interventions. The self-rating anxiety/depression scale (SAS/SDS), Athens insomnia scale (AIS), and impact of events scale-revised (IES-R) scores were assessed at enrollment (W0) and 12 weeks after the initiation of the intervention (W12); score changes (W0-W12) were also calculated.

RESULTS

Scores of the scales at W0 did not differ between groups (all P > 0.05). The WERC group showed a lower SAS score at W12 (P = 0.045) and greater change in SAS score (P < 0.001) than the NC group. The SDS score at W12 was not different (P = 0.119), while SDS score change was numerically greater (P = 0.076) in the WERC group than the NC group. Compared with the NC group, the WERC group tended toward a decreased AIS score at W12 (P = 0.054) and a greater AIS score change (P < 0.001). The IES-R score at W12 was lower (P = 0.040), and the IES-R score change was greater (P = 0.013) in the WERC group than the NC group.

CONCLUSION

A 12-week WERC ameliorates psychological disorders and insomnia better than NC in parents of childhood lymphoma patients.

Effects of medical and nursing group rounds combined with emotional nursing on quality of life and emotion in patients with malignant lymphoma

To investigate the effects of medical and nursing visits in the same group combined with emotional care on the quality of life and emotions of patients with malignant lymphoma. One hundred sixty cases of malignant lymphoma patients admitted to our hospital from March 2020 to July 2022 were selected as retrospective study subjects and divided into 80 cases each in the control group and the observation group according to the different nursing methods. Among them, the control group implemented conventional emotional care, and the observation group implemented medical and nursing visits in the same group on the basis of the control group. The differences in quality of life, anxiety-related scores and sleep quality between the 2 groups of patients with malignant lymphoma before and after nursing were compared. After nursing, the mental vitality (P = .015), social interaction (P < .001), emotional restriction (P = .007), and mental status (P = .028) scores of patients in the observation group were higher than those in the control group. After nursing, the Self-Rating Anxiety Scale (P < .001) and Hamilton Anxiety Scale (P < .001) of malignant lymphoma patients in the observation group were significantly lower than those in the control group, and the sleep quality (P < .001), increased awakening (P < .001), sleep disturbance (P < .001), night terrors (P < .001) scores in the observation group were significantly lower than those in the control group. The combination of medical and nursing group checkups and emotional care can effectively improve the quality of life and sleep of patients with malignant lymphoma and reduce adverse emotions, which is beneficial to patient prognosis and clinical treatment. It has certain reference value for the care of patients with malignant lymphoma.

Brentuximab-Induced Peripheral Neurotoxicity: A Multidisciplinary Approach to Manage an Emerging Challenge in Hodgkin Lymphoma Therapy

Brentuximab vedotin (BV) is an anti-CD30 antibody-drug conjugate approved to treat classical Hodgkin lymphoma (HL). BV-induced peripheral neurotoxicity (BVIN) is one of the greatest concerns for haematologists treating HL for several reasons. First, BVIN is highly frequent. Most patients receiving BV will experience some degree of BVIN, resulting in the primary reason for dose modification or discontinuation of HL therapy. Second, BV produces sensory, motor, and/or autonomic peripheral nerve dysfunction, which can present as severe, disabling forms of BVIN-predominantly motor-in some patients. Third, although largely reversible, BVIN may persist months or years after treatment and thereby become a major issue in HL survivorship. BVIN may, therefore, negatively affect the quality of life and work-life of often young patients with HL, in whom long-term survival is expected. Currently, the only strategy for BVIN includes dose adjustments and treatment discontinuation; however, this could interfere with LH therapy efficacy. In this setting, early recognition and adequate management of BVIN are critical in improving clinical outcomes. Careful neurologic monitoring may allow accurate diagnoses and gradation of ongoing forms of BVIN presentation. This review analysed current, available data on epidemiology, pathophysiology, patient- and treatment-related risk factors, clinical and neurophysiologic phenotypes, and management in patients with HL. Furthermore, this review specifically addresses limitations posed by BVIN assessments in clinical practice and provides skills and tools to improve neurologic assessments in these patients. Integrating this neurotoxic drug in clinical practice requires a multidisciplinary approach to avoid or minimise neurotoxicity burden in survivors of HL.