Abstract
The literature suggests that cancer survivors with more aggressive treatments are more at risk for postcancer fatigue. In this study, we investigated the prevalence of fatigue after completion of stem cell transplantation (SCT). Furthermore, we studied if medical variables are associated with fatigue and if the model of perpetuating factors of postcancer fatigue derived from previous studies in cancer survivors, without SCT, is applicable in SCT survivors. Ninety-eight patients treated with autologous or allogeneic SCT filled out several questionnaires. Medical characteristics were obtained from the medical charts. All patients had to be in persistent complete remission for at least 1 year. Thirty-five per cent of the patients experienced severe fatigue. The percentage of patients with severe fatigue remained stable during the years after transplantation. Several psychosocial factors, but no medical factors, were associated with fatigue. The model of perpetuating factors appeared to be applicable. Contrary to cancer survivors without SCT, we found no decrease in fatigue complaints during the first years after SCT. Cognitive behaviour therapy (CBT) is a general form of psychotherapy directed at changing condition-related cognitions and behaviours. CBT especially designed for postcancer fatigue, aimed at perpetuating factors, can also be used to manage fatigue in cancer survivors treated with SCT.
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References
Hjermstad MJ, Evensen SA, Kvaloy SO, Fayers PM, Kaasa S . Health-related quality of life 1 year after allogeneic or autologous stem-cell transplantation: a prospective study. J Clin Oncol 1999; 17: 706–718.
Hjermstad MJ, Holte H, Evensen SA, Fayers PM, Kaasa S . Do patients who are treated with stem cell transplantation have a health-related quality of life comparable to the general population after 1 year? Bone Marrow Transplant 1999; 24: 911–918.
Hjermstad MJ, Knobel H, Brinch L, Fayers PM, Loge JH, Holte H et al. A prospective study on health-related quality of life, fatigue, anxiety and depression 3–5 years after stem cell transplantation. Bone Marrow Transplant 2004; 34: 257–266.
Lee SJ, Fairclough D, Parsons SK, Soiffer RJ, Fisher DC, Schlossman RL et al. Recovery after stem-cell transplantation for hematologic diseases. J Clin Oncol 2001; 19: 242–252.
Bush NE, Donaldson GW, Haberman MH, Dacanay R, Sullivan KM . Conditional and unconditional estimation of multidimensional quality of life after hematopoietic stem cell transplantation: a longitudinal follow-up of 415 patients. Biol Blood Marrow Transplant 2000; 6: 576–591.
Neitzert CS, Ritvo P, Dancey J, Weiser K, Murray C, Avery J . The psychosocial impact of bone marrow transplantation: a review of the literature. Bone Marrow Transplant 1998; 22: 409–422.
Hann D, Jacobsen PB, Martin SC, Kronish LE, Azzarello LM, Fields KK . Fatigue in women treated with bone marrow transplantation for breast cancer: a comparison with women with no history of cancer. Support Care Cancer 1997; 5: 44–52.
Andrykowski MA, Bishop MM, Hahn EA, Cella DF, Beaumont JL, Brady MJ et al. Long-term health related quality of life, growth, and spiritual well-being after hematopoietic stem cell transplantation. J Clin Oncol 2005; 23: 599–608.
Knobel H, Loge JH, Nordoy T, Kolstad AL, Espevik T, Kvaloy S, Kaasa S . High level of fatigue in lymphoma patients treated with high dose therapy. J Pain Symptom Manage 2000; 19: 446–456.
Servaes P, Verhagen C, Bleijenberg G . Fatigue in cancer patients during and after treatment: prevalence, correlates and interventions. Eur J Cancer 2002; 38: 27–43.
Prue G, Rankin J, Allen J, Gracey J, Cramp F . Cancer related fatigue: a critical appraisal. Eur J Cancer 2006; 42: 846–863.
Bower JE, Ganz PA, Desmond KA, Bernaards C, Rowland JH, Meyerowitz BE et al. Fatigue in long-term breast carcinoma survivors. A longitudinal investigation. Cancer 2006; 106: 751–758.
Servaes P, Verhagen C, Schreuder BHW, Veth RPH, Bleijenberg G . Fatigue after treatment for malignant and benign bone and soft tissue tumors. J Pain Symptom Manage 2003; 26: 1113–1122.
Woo B, Dibble SL, Piper BF, Keating SB, Weiss MC . Differences in fatigue by treatment methods in women with breast cancer. Oncol Nurs Forum 1998; 25: 915–920.
Hjermstad SD, Fosså SD, Oldervoll L, Holte H, Jacobsen AB, Loge JH . Fatigue in long-term Hodgkin's disease survivors: a follow-up study. J Clin Oncol 2005; 23: 6587–6595.
Young KE, White CA . The prevalence and moderators of fatigue in people who have been successfully treated for cancer. J Psychosom Res 2006; 60: 29–38.
Ng AK, Li S, Recklitis C, Neuberg D, Chakrabartis S, Silver B et al. A comparison between long-term survivors of Hodgkin's disease and their siblings on fatigue level and factors predicting for increased fatigue. Ann Oncol 2005; 16: 1949–1955.
Gielissen MFM, Verhagen C, Witjes JA, Bleijenberg G . Effects of cognitive behavior therapy in severely fatigued disease-free cancer patients compared with patients waiting for cognitive behavior therapy: a randomized controlled trial. J Clin Oncol 2006; 23: 4882–4887.
Servaes P, Verhagen C, Bleijenberg G . Determinants of chronic fatigue in disease-free breast cancer patients, a cross-sectional study. Ann Oncol 2002; 13: 589–598.
Broeckel JA, Jacobsen PB, Horton J, Balducci L, Lyman GH . Characteristics and correlates of fatigue after adjuvant chemotherapy for breast cancer. J Clin Oncol 1998; 16: 1689–1696.
Glucksberg H, Storb R, Fefer A, Buckner CD, Neiman PE, Clift RA et al. Clinical manifestations of graft-versus-host disease in human recipients of marrow from HLA-matched sibling donors. Transplantation 1974; 18: 295–304.
Shulman HM, Sullivan KM, Weiden PL, McDonald GB, Striker GE, Sale GE et al. Chronic graft-versus-host syndrome in man. Am J Med 1980; 69: 204–217.
Vercoulen JHHM, Swanink CMA, Fennis JFM, Galama JMD, van der Meer JWM, Bleijenberg G . Dimensional assessment of chronic fatigue syndrome. J Psychosom Res 1994; 38: 383–392.
Beurskens AJHM, Bultman U, Kant IJ, Vercoulen JHMM, Bleijenberg G, Swaen GMH . Fatigue among working people: validity of a questionnaire measure. Occup Environ Med 2000; 57: 353–357.
Dittner AJ, Wessley SC, Brown RG . The assessment of fatigue: a practical guide for clinicians and researchers. J Psychosom Res 2004; 56: 157–170.
Reeves WC, Lloyd A, Vernon SD, Klimas N, Jason LA, Bleijenberg G et al. The Intrenational Chronic Fatigue Syndrome Study Group. Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution. BMC Health Serv Res 2003; 3: 25.
Servaes P, Gielissen MFM, Verhagen S, Bleijenberg G . The course of severe fatigue in disease-free breast cancer patients: a longitudinal study. Psycho-Oncology (E-pub ahead of print).
Servaes P, Prins J, Verhagen S, Bleijenberg G . Fatigue after breast cancer and in chronic fatigue syndrome: similarities and differences. J Psychosom Res 2002; 52: 453–459.
Stulemeijer M, de Jong LWAM, Fiselier TJW, Hoogveld SWB, Bleijenberg G . Cognitive behaviour therapy for adolescents with chronic fatigue syndrome: randomised controlled trial. Br Med J 2005; 330: 14.
Prins JB, Bleijenberg G, Bazelmans E, Elving LD, de Boo ThM, Severens JL et al. Cognitive behaviour therapy for chronic fatigue syndrome: a multicentre randomised controlled trial. Lancet 2001; 357: 841–847.
Brom D, Kleber RJ . De Schok Verwerkings Lijst [the impact of event scale – Dutch adaptation]. Ned Tijdschr Psych 1985; 40: 164–168.
Van der Ploeg E, Mooren TTM, Kleber RJ, van der Velden PG, Brom D . Construct validation of the Dutch version of the impact of event scale. Psych Assess 2004; 16: 16–26.
Creamer M, Bell R, Failla S . Psychometric properties of the impact of event scale – revised. Behav Res Ther 2003; 41: 1489–1496.
Vercoulen JH, Swanink CM, Galama JM, Fennis JFM, Jongen PJH, Hommes OR et al. The persistence of fatigue in chronic fatigue syndrome and multiple sclerosis: development of a model. J Psychosom Res 1998; 45: 507–517.
Bergner M, Bobbitt RA, Carter WB, Gilson BS . The sickness impact profile. Development and final revision of a health status measure. Med Care 1981; 19: 787–805.
Jacobs HM, Luttik A, Touw-Otten FW, de Melker RA . The sickness impact profile; results of an evaluation study of the Dutch version] De ‘sickness impact profile’; resultaten van een valideringsonderzoek van de Nederlandse Versie. Ned Tijdschr Geneeskd 1990; 134: 1950–1954.
Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull M, Duez NJ et al. The European organization for research and treatment of cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993; 85: 365–376.
World Health Organization. Group of Experts. Nutritional Anaemias. WHO Technical report series no. 503. WHO: Geneva, 1972.
Pronk-Admiraal CJ, Van Alphen-Jager JM, Herruer MH . Regionale uniformering van hematologische referentiewaarden. Ned Tijdschr Klin Chem 1997; 22: 192–194.
Report of a WHO consultation. Obesity: preventing, managing the global epidemic. 2000; 894: I–XII, 1–253. World Health Organization. World Health Organ Tech Rep Sez.
Bower JE, Ganz PA, Desmond KA, Rowland JH, Meyerowitz BE, Belin TR . Fatigue in breast cancer survivors: occurrence, correlates, and impact on quality of life. J Clin Oncol 2000; 18: 743–753.
Sugawara Y, Akechi T, Okuyama T, Matsuoka Y, Nakano T, Inagati M et al. Occurrence of fatigue and associated factors in disease-free cancer patients without depression. Support Care Cancer 2005; 13: 628–636.
Loge HJ, Abrahamsen AF, Ekeberg O, Kaasa S . Fatigue and psychiatric morbidity among Hodgkin's disease survivors. J Pain Symptom Manage 2000; 19: 91–99.
Fossa SD, Dahl AA, Loge JH . Fatigue, anxiety and depression in long-term survivors of testicular cancer. J Clin Oncol 2003; 21: 1249–1254.
De Jong N, Candel MJJM, Schouten HC, Huijer Abu-Saad H, Courtens AM . Prevalence and course of fatigue in breast cancer patients receiving adjuvant chemotherapy. Ann Oncol 2004; 15: 896–905.
Gratwohl A, Baldomero H, Frauendorfer K, Urbano-Ispizua A, Niederwieser D, For the joint accreditation committee of the International Society for Cellular Therapy ISCT and the European Group for Blood and Marrow Transplantation EBMT (JACIE). Results of the EBMT activity survey 2005 on haematopoietic stem cell transplantation: focus on increasing use of unrelated donors. Bone Marrow Transplant 2007; 39: 71–87.
Zittoun R, Suciu S, Watson M, Solbu G, Muus P, Mandelli F et al. Quality of life in patients with acute myelogenous leukemia in prolonged first complete remission after bone marrow transplantation (allogeneic or autologous) or chemotherapy: a cross-sectional study of the EORTC-GIMEMA AML 8a trial. Bone Marrow Transplant 1997; 20: 307–315.
Andrykowsky MA, Greiner CB, Altmaier EM, Burish TG, Antin JH, Gingrich R et al. Quality of life following bone marrow transplantation: findings from a multicentre study. Brit J Cancer 1995; 71: 1322–1329.
Meyers CA, Wietzner M, Byrne K, Valentine A, Champlin RE, Przepiorka D . Evaluation of the neurobehavioural functioning of patients before, during and after bone marrow transplantation. J Clin Oncol 1994; 12: 820–826.
Prieto JM, Saez R, Carreras E, Atala J, Sierra J, Rovira M et al. Physical and psychosocial functioning of 117 survivors of bone marrow transplantation. Bone Marrow Transplant 1996; 17: 1133–1142.
Acknowledgements
We thank all the patients who gave their time to participate in the study. Carmen Ariens and Tiny Fasotti for assisting in data collection. Funding for this study was provided by the Interzol, Comprehensive Cancer Centre South.
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Gielissen, M., Schattenberg, A., Verhagen, C. et al. Experience of severe fatigue in long-term survivors of stem cell transplantation. Bone Marrow Transplant 39, 595–603 (2007). https://doi.org/10.1038/sj.bmt.1705624
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DOI: https://doi.org/10.1038/sj.bmt.1705624
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