Experience of severe fatigue in long-term survivors of stem cell transplantation

Gielissen, Marieke; Schattenberg, A.V.M.B.; Verhagen, C.A.H.H.V.M.; Rinkes, M.J.; Bremmers, M.E.J.; Bleijenberg, Gijs

doi:10.1038/sj.bmt.1705624

Cited by 93 publications

(69 citation statements)

References 43 publications

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“…Most studies on post-cancer fatigue do not find an association between fatigue and cancer type (Servaes et al, 2002b;Prue et al, 2006;Gielissen et al, 2007). In the current study, we did not find a significant difference in fatigue severity at baseline between the different types of cancer (P ¼ 0.821).…”

Section: Discussioncontrasting

confidence: 76%

Cognitive behaviour therapy for fatigued cancer survivors: long-term follow-up

2007

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An earlier randomised-controlled trial demonstrated the positive effects of cognitive behaviour therapy (CBT), especially designed for fatigued cancer survivors in reducing fatigue, functional impairments and psychological distress. In the current prospective study, we were able to examine the long-term effect of CBT in patients who completed the therapy. Predictors of fatigue severity at follow-up were exploratory investigated. Sixty-eight patients who completed CBT were assessed at pretreatment, post-treatment and at follow-up (mean follow-up 1.9 years (s.d. 1.0), range: 1 -4 years). To analyse possible predictors of treatment outcome a linear regression (enter) was carried out. Improvements on fatigue severity, functional impairment and psychological distress after CBT appeared to remain stable during a follow-up period. Patients who were not fatigued anymore at follow-up were not different from a reference group of non-fatigued cancer survivors. The explorative regression analysis showed that fatigue severity, psychological distress and somatic attributions at pretreatment contributed to persistent fatigue severity at follow-up. Cognitive behaviour therapy, especially designed for post-cancer fatigue, is successful in reducing fatigue and functional impairment in cancer survivors. Moreover, these positive effects were maintained at about 2 years after finishing CBT.

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Section: Discussioncontrasting

confidence: 76%

Cognitive behaviour therapy for fatigued cancer survivors: long-term follow-up

2007

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“…In multivariable analysis, inactivity and symptom bother because of breathing symptoms and muscle/joint symptoms were significantly associated with being fatigued. Though prior research has not addressed fatigue specifically in cGvHD patient populations, Gielissen et al 15 examined fatigue in HCT survivors and noted that almost one-third of their respondents were fatigued. The presence of comorbidities was the only factor found to be significantly associated with fatigue; underlying diagnosis, time since transplantation, acute GvHD, duration of hospitalization, medication use, hemoglobin and body mass index were not associated with fatigue.…”

Section: Discussionmentioning

confidence: 99%

“…[9][10][11][12][13] The prevalence of fatigue in HCT has been estimated to range from 56 to 65%, and one-third of fatigued patients rate their fatigue as severe or distressing. [14][15][16] Moderate to severe fatigue can persist for years after HCT, and its etiology is likely multifactorial. [17][18][19] Although fatigue in patients with cGvHD has not been well characterized, cGvHD itself has a significant negative impact on quality of life and function, and symptom burden is an important component of these adverse outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…[20][21][22][23][24][25] Although studies indicate that patients with cGvHD report more fatigue compared with those without cGvHD, the factors associated with fatigue in this patient population have not been studied. 15,26,27 The etiology of fatigue in cancer survivors likely involves the interaction of several mechanisms, and a number of explanatory models of the psychophysiology of fatigue have been proposed. 28 Risk factors for fatigue following cancer treatment can include anemia, comorbidities, concurrent symptoms, impaired sleep quality, mood disturbance, cachexia, sarcopenia, deconditioning and treatment with medications with sedating side effects.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and determinants of fatigue in patients with moderate to severe chronic GvHD

Mitchell

Steinberg

et al. 2016

Bone Marrow Transplant

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Although fatigue is common after allogeneic hematopoietic cell transplantation, little is known about fatigue in patients with chronic GvHD (cGvHD). The aim of this study was to explore factors associated with fatigue in cGvHD. Data were drawn from a sequentially recruited, cross-sectional study of adults with moderate or severe cGvHD (n = 263). Respondents were classified as fatigued or not fatigued based on their response to a single item regarding loss of energy from the Lee cGvHD Symptom Scale. In univariate analysis, factors significantly associated with fatigue included performance status, number of prior cGvHD therapies, cGvHD symptom bother, self-assessed physical and mental health, nutritional status, walk velocity and self-reported physical activity. There were no significant associations between fatigue and disease-related cGvHD variables. Multivariable logistic regression demonstrated that being less active and having pulmonary and/or muscle/joint symptoms were independently associated with fatigue. In conclusion, clinically significant fatigue was prevalent in more than one-third of subjects with cGvHD, and was disabling. Absence of association with measures of cGvHD severity underscores the need to elucidate the pathogenesis of fatigue and its relationship with inflammatory activity. Pulmonary and muscle/joint symptoms and physical inactivity represent potential targets for intervention in clinical studies.

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“…The identification of a cluster comprised of fatigue, worry and appearance change prior to transplant has not been previously described. Recent studies reveal that fear of disease relapse [76], poor body image [77] and psychological distress [78] predict higher levels of fatigue in cancer survivors. However, a more complete description of the prevalence and correlates of this three symptom cluster in patients preparing for allogeneic HSCT is indicated.…”

Section: Discussionmentioning

confidence: 99%

The symptom experience in the first 100 days following allogeneic hematopoietic stem cell transplantation (HSCT)

Bevans

Mitchell

Marden

2008

Support Care Cancer

180

133

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Goals of Work-Despite advances in allogeneic hematopoietic stem cell transplantation (HSCT), post-transplant complications are common and patients' symptom experience has not been well documented.Purpose-To characterize the symptom experience of adult patients pre-transplantation and days 0, 30 and 100 after allogeneic HSCT.Methods-Data from 76 participants enrolled in a prospective Health-Related Quality of Life (HRQL) study were used. Symptom occurrence, distress, and clusters were determined based on the 11 symptoms of the Symptom Distress Scale (SDS).Results-Participants were on average 40 years old (SD ± 13.5). The majority (54%) received reduced intensity conditioning. Prevalent symptoms included fatigue (68%) and worry (68%) at baseline; appetite change (88%) at day 0; and fatigue at days 30 (90%) and 100 (81%). Participants reported the following symptoms as severely distressing: worry (16%) [baseline], insomnia (32%) [Day 0], appetite change (22%) [Day 30] and fatigue (11%) [Day 100]. The total SDS score was highest at day 0 (M = 26.6 ± 7.6) when the highest number of symptoms were reported [Mdn = 8 (1 -11)]. Symptoms formed clusters comprised of fatigue, appearance change, and worry at baseline, and fatigue, insomnia and bowel changes at days 0 and 30. Compared to those with low symptom distress, participants with moderate/severe symptom distress reported poorer HRQL. Conclusion-AllogeneicHSCT patients present for transplantation with low symptom distress yet experience multiple symptoms and high symptom distress after HSCT conditioning. Understanding the symptom experience of allogeneic HSCT patients can guide management strategies and improve HRQL.

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Experience of severe fatigue in long-term survivors of stem cell transplantation

Cited by 93 publications

References 43 publications

Cognitive behaviour therapy for fatigued cancer survivors: long-term follow-up

Cognitive behaviour therapy for fatigued cancer survivors: long-term follow-up

Prevalence and determinants of fatigue in patients with moderate to severe chronic GvHD

The symptom experience in the first 100 days following allogeneic hematopoietic stem cell transplantation (HSCT)

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