Abstract: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 univaria… Show more
“…This implies that prior research has focused on patients within the first 100 days after transplant in which fatigue is highly prevalent and can occur in up to 90% of the patients [5]. Yet, studies in HSCT have shown that fatigue may persist for long after day 100 [6][7][8] and therefore studies are needed to evaluate complementary therapies not only during the initial 100 days after transplant, but also during the extended survivorship period. In summary, none of the studies provided definitive evidence of the benefit for any of the therapies discussed.…”
Section: Discussionmentioning
confidence: 99%
“…In a study that evaluated fatigue in 76 adult allogeneic HSCT recipients, 68% reported fatigue on the day of transplant, 90% at day 30, and 81% at day 100 posttransplant [5]. Despite that fatigue tends to improve after day 100, studies in HSCT survivors have shown that some level of fatigue may persist for years after the initial 100 days [6][7][8]. In a study that evaluated the quality of life in 406 adult HSCT survivors, investigators found that 56% of the patients continued to suffer from fatigue for 1-3 years after transplant [6].…”
Section: Introductionmentioning
confidence: 99%
“…In another study measuring the prevalence of fatigue in 98 adult HSCT survivors, 35% had persistent severe fatigue, without improvement for up to 15 years after transplant [7]. Recent evidence also indicates that graft-versus-host disease (GVHD) may worsen fatigue in HSCT survivors [8], likely also due to a high inflammatory state. In a survey of 263 patients with moderate to severe chronic GVHD, 84% reported any degree of fatigue and 40% reported fatigue that was described as quite or extremely bothersome [8].…”
Section: Introductionmentioning
confidence: 99%
“…Recent evidence also indicates that graft-versus-host disease (GVHD) may worsen fatigue in HSCT survivors [8], likely also due to a high inflammatory state. In a survey of 263 patients with moderate to severe chronic GVHD, 84% reported any degree of fatigue and 40% reported fatigue that was described as quite or extremely bothersome [8].…”
Fatigue after hematopoietic stem cell transplantation (HSCT) is a persistent problem that limits activities and causes distress. Complementary therapies have shown promising results in improving fatigue in several patient populations. However, it is unknown whether they have the same effect on fatigue in the HSCT population. This integrative review aimed to explore the literature that evaluated complementary therapies for fatigue among HSCT patients. Only eight studies were considered eligible for inclusion in this review. The eight studies evaluated music therapy, relaxation, mindfulness, and massage techniques with mixed results. These studies had major methodological limitations, such as the small sample sizes and not blinding participants to the treatment allocation, introducing possible bias. Furthermore, most of these studies used 'usual care' control groups, leaving it unclear to what extent the observed effects are based on the effects of complementary therapies, or rather on psychosocial factors such as personal attention. More research is needed to more rigorously evaluate these and other complementary therapies for the prevalent problem of fatigue in the HSCT population.
“…This implies that prior research has focused on patients within the first 100 days after transplant in which fatigue is highly prevalent and can occur in up to 90% of the patients [5]. Yet, studies in HSCT have shown that fatigue may persist for long after day 100 [6][7][8] and therefore studies are needed to evaluate complementary therapies not only during the initial 100 days after transplant, but also during the extended survivorship period. In summary, none of the studies provided definitive evidence of the benefit for any of the therapies discussed.…”
Section: Discussionmentioning
confidence: 99%
“…In a study that evaluated fatigue in 76 adult allogeneic HSCT recipients, 68% reported fatigue on the day of transplant, 90% at day 30, and 81% at day 100 posttransplant [5]. Despite that fatigue tends to improve after day 100, studies in HSCT survivors have shown that some level of fatigue may persist for years after the initial 100 days [6][7][8]. In a study that evaluated the quality of life in 406 adult HSCT survivors, investigators found that 56% of the patients continued to suffer from fatigue for 1-3 years after transplant [6].…”
Section: Introductionmentioning
confidence: 99%
“…In another study measuring the prevalence of fatigue in 98 adult HSCT survivors, 35% had persistent severe fatigue, without improvement for up to 15 years after transplant [7]. Recent evidence also indicates that graft-versus-host disease (GVHD) may worsen fatigue in HSCT survivors [8], likely also due to a high inflammatory state. In a survey of 263 patients with moderate to severe chronic GVHD, 84% reported any degree of fatigue and 40% reported fatigue that was described as quite or extremely bothersome [8].…”
Section: Introductionmentioning
confidence: 99%
“…Recent evidence also indicates that graft-versus-host disease (GVHD) may worsen fatigue in HSCT survivors [8], likely also due to a high inflammatory state. In a survey of 263 patients with moderate to severe chronic GVHD, 84% reported any degree of fatigue and 40% reported fatigue that was described as quite or extremely bothersome [8].…”
Fatigue after hematopoietic stem cell transplantation (HSCT) is a persistent problem that limits activities and causes distress. Complementary therapies have shown promising results in improving fatigue in several patient populations. However, it is unknown whether they have the same effect on fatigue in the HSCT population. This integrative review aimed to explore the literature that evaluated complementary therapies for fatigue among HSCT patients. Only eight studies were considered eligible for inclusion in this review. The eight studies evaluated music therapy, relaxation, mindfulness, and massage techniques with mixed results. These studies had major methodological limitations, such as the small sample sizes and not blinding participants to the treatment allocation, introducing possible bias. Furthermore, most of these studies used 'usual care' control groups, leaving it unclear to what extent the observed effects are based on the effects of complementary therapies, or rather on psychosocial factors such as personal attention. More research is needed to more rigorously evaluate these and other complementary therapies for the prevalent problem of fatigue in the HSCT population.
“…However, cure or control of the underlying primary disease and effective management of transplant-related late complications, may not be accompanied by a full recovery of health status. Late complications including symptom burden (pain, fatigue, insomnia) and chronic graft-versus-host-disease (cGVHD) associated functional impairments are a major contributor to impairments in quality of life among HCT survivors [2][3][4][5]. Given these difficulties, patients may find it challenging to engage in or resume valued activities and daily roles that support higher levels of social well-being including sustaining intimate relationships and participating in activities with friends or family [6].…”
Although the majority of survivors are well adjusted, subgroups may experience significant poor social adjustment. Specifically, survivors with fatigue are at risk to experience lower levels of social adjustment. Development of effective rehabilitation strategies to improve affected areas of social health is warranted, and all HCT survivors should be screened periodically for social maladjustment and provided with resources and referrals.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.