Purpose: To explore the mediating effect of symptom burden between fear of disease progression and financial toxicity in patients with non-Hodgkin lymphoma. Methods: A total of 236 patients with non-Hodgkin lymphoma from the oncology department of a tertiary grade -A hospital were investigated, using the general situation questionnaire, comprehensive scores for financial toxicity based on the patient-reported outcome measures (COST-PROM), memorial symptom assessment scale (MSAS) and fear of progression questionnaire-short form (FoP-Q-SF). Stepwise regression analysis was used for analysis, and AMOS 24.0 was used to establish structural equation model, and Bootstrap test was used to verify mediating effect. Results: The scores of financial toxicity, fear of progression and symptom burden of patients with non-Hodgkin lymphoma were 17 (12.00, 22.00), (33.92±6.87) and (0.64±0.30). Correlation analysis showed that fear of disease progression (r=-0.583, P<0.01) and symptom burden (r=-0.524, P<0.01) were negatively correlated with financial toxicity, and fear of progression was positively correlated with symptom burden. The results of mediating effect test showed that symptom burden played a partial mediating role between fear of progression and financial toxicity, and the mediating effect accounted for 26.00% of the total effect. Conclusion: Fear of progression could directly affect financial toxicity, and also indirectly affect financial toxicity of patients with non-Hodgkin lymphoma through symptom burden.

Non-Hodgkin Lymphoma, Financial Toxicity, Symptom Burden, Fear of Progression, Mediating Effect