Understanding the factors influencing quality of life among survivors of Non-Hodgkin lymphoma after completing primary treatment: a systematic review

Abstract

Purpose: To evaluate and synthesize the existing evidence on factors influencing the quality of life (QoL) of non-Hodgkin lymphoma (NHL) survivors and the impact of these factors on their QoL. Methods: A systematic review was conducted following PRISMA guidelines, with searches in CINAHL, MEDLINE, PubMed, ScienceDirect, Scopus, and Web of Science. Studies published between 2014 and 2025 were included if they were original English-language research involving adult (age ≥ 18 years) NHL survivors and focused on factors affecting QoL. Exclusion criteria encompassed animal studies and nonoriginal research. Data synthesis and quality assessment utilized the convergent integrated analysis framework from the Joanna Briggs Institute to identify key themes across studies. Results: Nineteen studies (n = 8322) were included, revealing nine key themes: (1) personal characteristics (e.g., age and gender); (2) clinical characteristics (e.g., time since diagnosis and comorbidities); (3) physical concerns (e.g., fatigue and symptom burden); (4) psychological concerns (e.g., anxiety, depression, and PTG); (5) lifestyle factors (e.g., diet and exercise); (6) sexual health (e.g., satisfaction and erectile dysfunction); (7) economic status (e.g., employment and financial strain); (8) supporting systems (e.g., unmet needs), and (9) area of residence (e.g., rural residence). Conclusions: This review highlights the multifactorial influences on QoL in NHL survivors, emphasizing the need for integrated survivorship care that addresses physical, psychological, and social dimensions to improve long-term outcomes. Healthcare providers should prioritize individualized care plans addressing both physical and psychosocial challenges, with digital health interventions, especially for rural populations, to enhance QoL outcomes.