NFLymSI-18 Validated for iNHL: Key Symptom Coverage Confirmed

July, 07, 2024 | Lymphoma


  • The study aimed to assess the NFLymSI-18 content validity, focusing on DRS-P subscale, for pts with iNHL.
  • Researchers validated the NFLymSI-18 content for iNHL, covering key symptoms: swelling, fatigue, pain.

The NFLymSI-18 is a patient-reported outcome measure that includes the highest priority symptoms, emotional concerns, treatment side effects, and other concerns identified by patients (pts) with lymphoma and their oncologists.

Courtney N Hurt and the team aimed to evaluate and validate the content of the NFLymSI-18, with a predominant focus on the disease-related symptoms physical (DRS-P) subscale, for pts with indolent B-cell non-Hodgkin’s lymphoma (iNHL).

Researchers recruited pts during clinic visits having a confirmed iNHL diagnosis who had received 1 or more lines of treatment. Description of symptoms, treatment side effects, and emotional concerns were recorded during a semi-structured interview. NVivo10 was employed for the qualitative analysis of the data.

Results revealed that data saturation was obtained by the 18th interview. About 67% of pts had follicular lymphoma (FL), 28 % had marginal zone lymphoma (MZL), and 1 patient had lymphoplasmacytic lymphoma/Waldenström macroglobulinemia. The mean age of the 18 pts was 67 years, with 56% of the sample population being males. Most of the recruited pts (67%) had a college or advanced degree.

During the semi-structured interview sessions, pts were asked for their iNHL symptoms, swelling (n= 14), fatigue (n= 11), and pain (n= 8) were most frequently reported by pts. Additionally, anxiety, appetite loss, rash, sleep disruption, trouble breathing, and malaise were each mentioned by 3 pts. Mapping of NFLymSI-18 content to patient-reported concerns advised that the instrument included all those most frequently mentioned symptoms.

The study affirmed the content validity of the NFLymSI-18, which included its DRS-P subscale, for pts with iNHL. A strong validity was demonstrated by the instrument for the most referenced symptoms of swelling, fatigue, and pain. The diversity of additional symptoms reported by pts was consistent with the heterogeneous symptomology of pts with iNHL.

The study was funded by Bayer Healthcare Pharmaceuticals.


Hurt CN, Kaiser K, Shaunfield S, et al. (2024). “Content validation of the National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy Lymphoma Symptom Index-18 (NFLymSI-18) in indolent B-cell non-Hodgkin’s lymphoma.” J Patient Rep Outcomes. 2024 Jul 9;8(1):68. doi: 10.1186/s41687-024-00752-6. PMID: 38980533.

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