Living after lymphoma: A retrospective study of survivorship outcomes from a tertiary cancer centre in rural India.

Abstract

e24130 Background: With improving survival in lymphoma, long-term treatment-related complications have emerged as a major determinant of quality of life. However, comprehensive survivorship data from India remain scarce. This study evaluates metabolic, endocrine, bone, cardiovascular, and psychosocial outcomes among adult lymphoma survivors at a tertiary cancer centre in rural India. Methods: This retrospective observational study included adult Hodgkin and non-Hodgkin lymphoma survivors treated between 2012 and 2022, who completed curative-intent therapy and remained disease-free for ≥3 years. Survivorship evaluations performed within the last 2 years were reviewed. Data on demographics, disease characteristics, treatment exposures, metabolic parameters, endocrine function, bone health, cardiovascular events, secondary malignancies, and psychosocial outcomes were analysed using descriptive statistics. Results: A total of 100 survivors were included (62 males, 38 females), with a median age of 58.5 years (range 24–81). Diagnoses included diffuse large B-cell lymphoma (45%), follicular lymphoma (17%), Hodgkin lymphoma (20%), and others (18%). Most patients had advanced disease (stage III–IV, 59%). Treatments included chemotherapy in 97% (R-CHOP 52, ABVD 19, BR 11, others 15), radiotherapy in 20%, and autologous stem cell transplant in 9%. Metabolic complications were common: obesity in 40.4%, hypertension in 31%, dyslipidemia in 56%, and diabetes mellitus in 31.1%. Mean BMI was 24.3±5.1 kg/m². Mean total cholesterol was 210±35 mg/dL, LDL 130±36 mg/dL, triglycerides 175±86 mg/dL, and HbA1c 6.38±1.1%. Hypothyroidism was detected in 8.4%. Vitamin D insufficiency or deficiency was observed in 76.5%. Bone health assessment revealed osteopenia in 37% and osteoporosis in 23%. Two patients developed new-onset left ventricular dysfunction, three experienced cerebrovascular events, and two developed premature cataracts before the age of 50. Two patients developed tuberculosis post-treatment. Second primary malignancies occurred in two patients (DLBCL→AML; ALCL→ Hodgkin lymphoma). Psychosocial impact was notable, with five patients remaining unmarried and one experiencing marital disruption attributed to fear of recurrence and social stigma. Conclusions: Lymphoma survivors in rural India experience a substantial burden of metabolic, skeletal, cardiovascular, and psychosocial complications. These findings highlight the urgent need for structured, multidisciplinary survivorship care models tailored to resource-limited settings to improve long-term outcomes and quality of life.