Abstract C064: Anemia, transfusions, and health-related quality of life in patients with advanced-stage classic Hodgkin lymphoma receiving multiagent therapy: Findings from the HD21 study

Abstract Introduction: The German Hodgkin Study Group (GHSG) HD21 trial of multiagent therapy in classic Hodgkin lymphoma (cHL) showed significantly reduced treatment-related morbidity (TRMB) with at least 1 TRMB reported in 42% and 59% of patients (pts) treated with BrECADD and eBEACOPP respectively. The HD21 study also showed a reduction in red blood cell (RBC) and platelet transfusions in BrECADD. Anemia is hypothesized to negatively impact pts’ health-related quality of life (HRQoL). This post-hoc analysis explored the association between anemia and HRQoL. Methods: The study randomized 1,500 pts (1:1) to BrECADD or eBEACOPP in 4 or 6, 21-day, treatment cycles. The patient-reported outcomes (PRO) measure European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire – Core 30 items (QLQ-C30) was administered at baseline, during the treatment and posttreatment follow-up (FU) periods up to 60 months. Physical functioning (PF), Social functioning (SF), and Fatigue (FA) were identified as key concepts that could be negatively associated with anemia. Anemia was assessed through RBC transfusions received (0 vs. 1 transfusion or more) and hemoglobin (Hgb) groups (≤8g/dL, >8g/dL but ≤10g/dL, >10g/dL but ≤12g/dL, and >12g/dL). PRO scores were described according to transfusions received and Hgb groups and multivariable analyses were conducted over the treatment period to describe scores according to Hgb groups, adjusted for the transfusions received, age, sex, international prognostic score groups, and baseline PRO score. As this was an exploratory post-hoc analyses, no formal statistical testing was performed; results are interpreted descriptively. Results: The PRO analysis set (all pts with a baseline PRO and at least one postbaseline PRO from the intent-to-treat population) included 732 pts (54% male, mean age 34 years, and 68% with baseline ECOG of 0). At restaging after chemotherapy (RaC), mean PRO score in pts without transfusions vs. pts with transfusion was 76.1 vs. 69.1 for PF, 59.7 vs. 49.5 for SF, and 49.8 vs. 56.1 for FA, respectively. Mean scores in pts with Hgb <8g/dL vs. Hgb ≥12g/dL ranged from 64.1 to 80.4 for PF, 47.4 to 62.8 for SF, and 58.1 to 45.2 for FA at RaC. These results suggest poorer physical and social functioning and more severe fatigue in pts with transfusion or with lower Hgb levels at RaC. Similar results were seen at Staging after 2 cycles. Multivariable analysis showed consistent results with mean estimates numerically lower (PF and SF) or higher (FA) in pts with Hgb <8g/dL than in pts with Hgb ≥12g/dL. Conclusion: These findings indicate a negative association between anemia and pts’ HRQoL, notably at the end of the treatment period suggesting that treatments addressing anemia may not only offer clinical benefit but could also enhance pts’ experience during treatment for advanced stage cHL. Citation Format: Fjoralba Kristo, Flora Mazerolle, Thibaud Alin, Antoine Regnault, Justin Ferdinandus, Karolin Behringer, Janina Jablonski, Peter Borchmann, Ajibade Ashaye. Anemia, transfusions, and health-related quality of life in patients with advanced-stage classic Hodgkin lymphoma receiving multiagent therapy: Findings from the HD21 study [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference on Molecular Targets and Cancer Therapeutics; 2025 Oct 22-26; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2025;24(10 Suppl):Abstract nr C064.