Frailty and associated factors in patients with non-Hodgkin lymphoma during chemotherapy: a longitudinal study

Purpose To investigate the dynamic changes of frailty and its associated factors in patients with non-Hodgkin lymphoma during chemotherapy. Method Using a convenience sampling method, 266 patients with non-Hodgkin lymphoma hospitalized in the Department of Hematology at five tertiary hospitals in China were recruited from January to August 2025. General information, frailty, cognition, physical performance, nutrition, and anxiety were investigated before chemotherapy (T0), at the third cycle (T1), and at the end of chemotherapy (T2). Generalized Estimating Equations were utilized to analyze the factors related to frailty. Results Finally, 252 patients completed the longitudinal follow-up. The mean frailty scores were 4.31 ± 2.46 (T0), 5.22 ± 2.59 (T1), and 4.50 ± 2.65 (T2). Generalized estimating equations results indicated that factors significantly associated with frailty included sociodemographic factors (level of education), treatment-related variables (dose reduction, treatment delay), nutritional and inflammatory factors (appetite loss, lymphocyte count, hemoglobin, C-reactive protein, CONUT score), physical function factors (grip strength, SPPB score), cognitive function (MoCA-B score), and psychological status (GAD-7 score) ( P < 0.05). Conclusions A substantial proportion of patients with non-Hodgkin lymphoma meet criteria for frailty during chemotherapy, with prevalence peaking at 59.3% at the end of the third cycle, and the observed trajectory of initial increase followed by decrease warrants cautious interpretation given the observational design. Dynamic monitoring and individualized supportive care are recommended, though interventional studies are needed to confirm whether frailty can be genuinely modified.