Persistent fatigue in hematopoietic stem cell transplantation survivors

Eileen Hacker, Anne M. Fink, Tara Peters, Chang Park, Giamila Fantuzzi, Damiano Rondelli

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Fatigue is highly prevalent after hematopoietic stem cell transplantation (HCT). It has been described as intense and may last for years following treatment. Objective: The aim of this study is to compare fatigue, physical activity, sleep, emotional distress, cognitive function, and biological measures in HCT survivors with persistent fatigue (n = 25) with age- and gender-matched healthy controls with occasional tiredness (n = 25). Methods: Data were collected using (a) objective, real-time assessments of physical activity and sleep over 7 days; (b) patient-reported fatigue assessments; (c) computerized objective testing of cognitive functioning; and (d) biological measures. Differences between groups were examined using multivariate analysis of variance. Results: Survivors of HCT reported increased physical (P <.001), mental (P <.001), and overall (P <.001) fatigue as well as increased anxiety (P <.05) and depression (P <.01) compared with healthy controls. Red blood cell (RBC) levels were significantly lower in HCT survivors (P <.001). Levels of RBC for both groups, however, were in the normal range. Tumor necrosis factor-α (P <.001) and interleukin-6 (P <.05) levels were significantly higher in HCT survivors. Conclusions: Persistent fatigue in HCT survivors compared with healthy controls with occasional tiredness is accompanied by increased anxiety and depression along with decreased RBC counts. Elevated tumor necrosis factor-α and interleukin-6 levels may be important biomarkers. Implications for Practice: This study provides preliminary support for the conceptualization of fatigue as existing on a continuum, with tiredness anchoring one end and exhaustion the other. Persistent fatigue experienced by HCT survivors is more severe than the occasional tiredness of everyday life.

Original languageEnglish (US)
Pages (from-to)174-183
Number of pages10
JournalCancer Nursing
Volume40
Issue number3
DOIs
StatePublished - May 1 2017
Externally publishedYes

Fingerprint

Hematopoietic Stem Cell Transplantation
Fatigue
Survivors
Interleukin-6
Sleep
Anxiety
Tumor Necrosis Factor-alpha
Erythrocytes
Exercise
Depression
Erythrocyte Count
Cognition
Analysis of Variance
Reference Values
Multivariate Analysis
Biomarkers

Keywords

  • Anxiety
  • Cancer survivors
  • Depression
  • Fatigue
  • Stem cell transplantation

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)

Cite this

Hacker, E., Fink, A. M., Peters, T., Park, C., Fantuzzi, G., & Rondelli, D. (2017). Persistent fatigue in hematopoietic stem cell transplantation survivors. Cancer Nursing, 40(3), 174-183. https://doi.org/10.1097/NCC.0000000000000405

Persistent fatigue in hematopoietic stem cell transplantation survivors. / Hacker, Eileen; Fink, Anne M.; Peters, Tara; Park, Chang; Fantuzzi, Giamila; Rondelli, Damiano.

In: Cancer Nursing, Vol. 40, No. 3, 01.05.2017, p. 174-183.

Research output: Contribution to journalArticle

Hacker, E, Fink, AM, Peters, T, Park, C, Fantuzzi, G & Rondelli, D 2017, 'Persistent fatigue in hematopoietic stem cell transplantation survivors', Cancer Nursing, vol. 40, no. 3, pp. 174-183. https://doi.org/10.1097/NCC.0000000000000405
Hacker, Eileen ; Fink, Anne M. ; Peters, Tara ; Park, Chang ; Fantuzzi, Giamila ; Rondelli, Damiano. / Persistent fatigue in hematopoietic stem cell transplantation survivors. In: Cancer Nursing. 2017 ; Vol. 40, No. 3. pp. 174-183.
@article{076ea376045d426cbb9190bc2653f42d,
title = "Persistent fatigue in hematopoietic stem cell transplantation survivors",
abstract = "Background: Fatigue is highly prevalent after hematopoietic stem cell transplantation (HCT). It has been described as intense and may last for years following treatment. Objective: The aim of this study is to compare fatigue, physical activity, sleep, emotional distress, cognitive function, and biological measures in HCT survivors with persistent fatigue (n = 25) with age- and gender-matched healthy controls with occasional tiredness (n = 25). Methods: Data were collected using (a) objective, real-time assessments of physical activity and sleep over 7 days; (b) patient-reported fatigue assessments; (c) computerized objective testing of cognitive functioning; and (d) biological measures. Differences between groups were examined using multivariate analysis of variance. Results: Survivors of HCT reported increased physical (P <.001), mental (P <.001), and overall (P <.001) fatigue as well as increased anxiety (P <.05) and depression (P <.01) compared with healthy controls. Red blood cell (RBC) levels were significantly lower in HCT survivors (P <.001). Levels of RBC for both groups, however, were in the normal range. Tumor necrosis factor-α (P <.001) and interleukin-6 (P <.05) levels were significantly higher in HCT survivors. Conclusions: Persistent fatigue in HCT survivors compared with healthy controls with occasional tiredness is accompanied by increased anxiety and depression along with decreased RBC counts. Elevated tumor necrosis factor-α and interleukin-6 levels may be important biomarkers. Implications for Practice: This study provides preliminary support for the conceptualization of fatigue as existing on a continuum, with tiredness anchoring one end and exhaustion the other. Persistent fatigue experienced by HCT survivors is more severe than the occasional tiredness of everyday life.",
keywords = "Anxiety, Cancer survivors, Depression, Fatigue, Stem cell transplantation",
author = "Eileen Hacker and Fink, {Anne M.} and Tara Peters and Chang Park and Giamila Fantuzzi and Damiano Rondelli",
year = "2017",
month = "5",
day = "1",
doi = "10.1097/NCC.0000000000000405",
language = "English (US)",
volume = "40",
pages = "174--183",
journal = "Cancer Nursing",
issn = "0162-220X",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Persistent fatigue in hematopoietic stem cell transplantation survivors

AU - Hacker, Eileen

AU - Fink, Anne M.

AU - Peters, Tara

AU - Park, Chang

AU - Fantuzzi, Giamila

AU - Rondelli, Damiano

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Background: Fatigue is highly prevalent after hematopoietic stem cell transplantation (HCT). It has been described as intense and may last for years following treatment. Objective: The aim of this study is to compare fatigue, physical activity, sleep, emotional distress, cognitive function, and biological measures in HCT survivors with persistent fatigue (n = 25) with age- and gender-matched healthy controls with occasional tiredness (n = 25). Methods: Data were collected using (a) objective, real-time assessments of physical activity and sleep over 7 days; (b) patient-reported fatigue assessments; (c) computerized objective testing of cognitive functioning; and (d) biological measures. Differences between groups were examined using multivariate analysis of variance. Results: Survivors of HCT reported increased physical (P <.001), mental (P <.001), and overall (P <.001) fatigue as well as increased anxiety (P <.05) and depression (P <.01) compared with healthy controls. Red blood cell (RBC) levels were significantly lower in HCT survivors (P <.001). Levels of RBC for both groups, however, were in the normal range. Tumor necrosis factor-α (P <.001) and interleukin-6 (P <.05) levels were significantly higher in HCT survivors. Conclusions: Persistent fatigue in HCT survivors compared with healthy controls with occasional tiredness is accompanied by increased anxiety and depression along with decreased RBC counts. Elevated tumor necrosis factor-α and interleukin-6 levels may be important biomarkers. Implications for Practice: This study provides preliminary support for the conceptualization of fatigue as existing on a continuum, with tiredness anchoring one end and exhaustion the other. Persistent fatigue experienced by HCT survivors is more severe than the occasional tiredness of everyday life.

AB - Background: Fatigue is highly prevalent after hematopoietic stem cell transplantation (HCT). It has been described as intense and may last for years following treatment. Objective: The aim of this study is to compare fatigue, physical activity, sleep, emotional distress, cognitive function, and biological measures in HCT survivors with persistent fatigue (n = 25) with age- and gender-matched healthy controls with occasional tiredness (n = 25). Methods: Data were collected using (a) objective, real-time assessments of physical activity and sleep over 7 days; (b) patient-reported fatigue assessments; (c) computerized objective testing of cognitive functioning; and (d) biological measures. Differences between groups were examined using multivariate analysis of variance. Results: Survivors of HCT reported increased physical (P <.001), mental (P <.001), and overall (P <.001) fatigue as well as increased anxiety (P <.05) and depression (P <.01) compared with healthy controls. Red blood cell (RBC) levels were significantly lower in HCT survivors (P <.001). Levels of RBC for both groups, however, were in the normal range. Tumor necrosis factor-α (P <.001) and interleukin-6 (P <.05) levels were significantly higher in HCT survivors. Conclusions: Persistent fatigue in HCT survivors compared with healthy controls with occasional tiredness is accompanied by increased anxiety and depression along with decreased RBC counts. Elevated tumor necrosis factor-α and interleukin-6 levels may be important biomarkers. Implications for Practice: This study provides preliminary support for the conceptualization of fatigue as existing on a continuum, with tiredness anchoring one end and exhaustion the other. Persistent fatigue experienced by HCT survivors is more severe than the occasional tiredness of everyday life.

KW - Anxiety

KW - Cancer survivors

KW - Depression

KW - Fatigue

KW - Stem cell transplantation

UR - http://www.scopus.com/inward/record.url?scp=84975481883&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84975481883&partnerID=8YFLogxK

U2 - 10.1097/NCC.0000000000000405

DO - 10.1097/NCC.0000000000000405

M3 - Article

C2 - 27333126

AN - SCOPUS:84975481883

VL - 40

SP - 174

EP - 183

JO - Cancer Nursing

JF - Cancer Nursing

SN - 0162-220X

IS - 3

ER -