Assessment of the Quality of Life of Patients with Primary Cutaneous T-cell Lymphoma

    V. Mateeva, M. Kadurina
    Department of Dermatovenereology and Allergology – Military Medical Academy, Sofia

    The aim of this study is to assess the quality of life of patients with primary cutaneous T-cell lymphomas (CTCL) and to assess the influence of the sex, age, stage of disease, time from appearance of the symptoms and time from diagnosis. A secondary objective was to evaluate the effect of treatment on HRQOL in patient with CTCL. CTCL are lymphoproliferative visible cutaneous malignancy with potentially significant impact on patients’ physical and psychological condition.
    Design: Monocentric, prospective study.
    Base: Clinic of Dermatovenereology and allergology – Military Medical Academy, Sofia
    Material and Methods: Twenty-seven patients with histological and immunohistochemical diagnosis of CLTL filled in once or several times the Skindex 16 questionnaire over an 1,5-year-period. Sixty-two questionnaires were filled in altogether. In 24 of the cases a treatment has been conducted and assessment has been made at the beginning and end of treatment.
    Results: There is no statistically significant difference between male and female patients regarding symptoms, emotions and functioning before and after treatment. There is a statistically significant correlation between the age and emotions, the emotional burden is greater in younger patient with CLTL (r=-0,407). There is no statistically significant difference between the different age groups regarding symptoms, emotions and functioning (Р = 0,106, Р = 0,557 and Р = 0,303, resp.). There is a statistically significant difference between the symptoms in early (IA-IIA) and late (IIB-IV) stage of disease (Р= 0,029). Treatment influences positively the emotions (p < 0,0001), with no significant influence on symptoms and functioning (P = 0,076, Р = 0,529). The greatest fear for patient independent from disease stage is that the condition could get worse. This is the greatest fear of female patients, while male patients are mostly affected by the skin appearance. Greatest burden on HRQOL is demonstrated in <52-year-old females in late disease stage. After treatment there is considerable reduction in the burden of skin apprearence, fear of recurrence and emberrassment (Р = 0,003, Р = 0,003, Р = 0,035).
    Conclusion: The Skindex 16 scales have high internal consistence and HRQOL of patients with CTCL could be evaluated using this instrument. Patients from both sexes suffer from the disease. Younger patients with CTCL are emotionally affected. Patient with late stage of the disease have significantly greater burden of symptoms such as prutitus and pain. Treatment improves mainly emotional quality of life of the patients.

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