Effects of nonpharmacological interventions on reducing fatigue after hematopoietic stem cell transplantation

Abstract

Fatigue is one of the main complaints of patients undergoing allogeneic and autologous hematopoietic stem cell transplantation (HSCT). Since nonpharmacological interventions are cost-effective and causes fewer complications, this study aimed to review the studies performed on the effects of nonpharmacological interventions on fatigue in patients undergoing HSCT during September 2016. MEDLINE, CINAHL, Scientific Information Database, IranMedex, PubMed, ScienceDirect, Scopus, Magiran, and IRANDOC databases were searched using Persian and English keywords. A total of 1217 articles were retrieved, 21 of which were used in this study. Exercise is known as an effective intervention in alleviating physical and mental problems of patients undergoing stem cell transplant. This review-based study showed that nonpharmacological methods such as exercise might be effective in decreasing fatigue in patients undergoing stem cell transplant. There is a multitude of studies on some of the complementary and alternative therapy methods, such as music therapy, yoga, relaxation, and therapeutic massage. These studies demonstrated the positive effects of the aforementioned therapies on reduction of fatigue in patients undergoing stem cell transplantation. All the investigated methods in this study were nonaggressive, safe, and cost-effective and could be used along with common treatments or even as an alternative for pharmacological treatments for the reduction, or elimination of fatigue in patients undergoing stem cell transplantation. Given the advantages of complementary and alternative medicine, conducting further studies on this issue is recommended to reduce fatigue in patients after stem cell transplantation.

Psychosocial interventions with art and music during stem cell transplantation: An integrative review

“…Though qualitative findings did not indicate that patient activity increased in the short term after the intervention, patient frustration and anxiety about fatigue had been dissipated following the music intervention and their motivation increased for more activity later. Since fatigue is one of the most distressing symptoms which patients undergoing transplant face (Jafari et al, 2017) this inverse association with relaxation is noteworthy.…”

Returning to employment following allogeneic hematopoietic stem cell transplant: A major problem among survivors

“…Other factors contributing to fatigue include electrolyte imbalance from the use of antibiotics and immunosuppressive agents, infections, severe anemia, sleep disorders in the hospital, stress, anxiety, and depression [23]. The prevalence of severe fatigue decreased gradually to 81% by day 100 [24], 41% in the first 5 years [24], and 32% between years 5 and 10 [24]. Unfortunately, the inability to return to employment intensifies the inactivity and may further exacerbate symptoms of fatigue.…”

Palliative care during and following allogeneic hematopoietic stem cell transplantation

“…Guidelines relevant for managing the common supportive care needs in patients undergoing HSCT are available from organizations such as the Oncology Nursing Society, National Comprehensive Cancer Network (NCCN), Multinational Association of Supportive Care in Cancer, American Psychosocial Oncology Society, and the American Society of Clinical Oncology, although few palliative and supportive care interventions have been specifically tested in HSCT recipients. Several recent reviews synthesize the evidence for the use of exercise and rehabilitation(40–42), yoga(43), and meditation(44), non-pharmacologic management of fatigue(45), management of neurocognitive dysfunction(46), sleep disruption(47), nutritional compromise(48), and mood disturbance and psychological distress(49), and the use of complementary and integrative treatments(50). Evidence-based guidelines for the surveillance and management of late effects and other supportive care concerns in HSCT survivors(51) and in HSCT survivors with cGVHD(52, 53) have been endorsed internationally.…”