High Level of Fatigue in Lymphoma Patients Treated With High Dose Therapy

Abstract

With the success of high dose therapy supported by autologous bone marrow transplantation (ABMT) for malignant lymphomas, medical late-effects and secondary effects on subjective health, like fatigue, are of concern. Fatigue is poorly understood and correlates have been barely addressed. Health-related quality of life (HRQL), fatigue, and correlates to fatigue, including endocrinological status and serum levels of interleukin-6, tumor necrosis factor, and soluble tumor necrosis factor receptors, were investigated in a cross-sectional study of 33 lymphoma patients (median age 39 years) 4-10 years after ABMT. The survivors were compared to general population norms. Fatigue was highly prevalent, and females reported significantly more fatigue and impaired HRQL compared to males and the normal population. Gonadal dysfunction was found in the majority of the patients, but no statistically significant endocrinological or immunological associations with fatigue could be demonstrated. The high level of fatigue among female long-term survivors after ABMT may be related to the gonadal dysfunction, but further studies of possible mechanisms behind fatigue are necessary.

High levels of untreated distress and fatigue in cancer patients

“…This is also consistent with other studies, and fatigue is beginning to be recognised as one of the most significant and long-term consequences of cancer and its treatment (Hann et al, 1997;Hann et al, 1999;Knobel et al, 2000;Okuyama et al, 2001). Of note is that almost half of all patients who were identified as suffering significant distress had not used psychosocial resources in the past or present, and did not intend to use the services in the future.…”

Fatigue in low-grade glioma

“…However, in most studies, no associations were found between tumor-related variables and fatigue intensity with regard to disease duration [23,25,26,29,[33][34][35], type of cancer [27,36], disease stage at diagnosis [23, 25-27, 33, 37], size of the original tumor [25,26,37], number of nodes involved [25] and tumor recurrence [33].…”

Cancer-related fatigue: Links with inflammation in cancer patients and survivors

“…The authors found no association between circulating levels of IL-1β and fatigue, although it should be noted that the levels of IL-1β in this report were extremely high (mean = 1,152pg/ml, range = 9 -3, 952pg/ml), well above levels seen in other groups of cancer patients and healthy individuals. Two other studies examined inflammatory parameters among patients with hematological malignancies who had completed treatment at least 3 months previously (Dimeo et al, 2004;Knobel et al, 2000). Neither study found an association between fatigue and markers of inflammation, including serum levels of IL-1β, IL-1ra, IL-6, neopterin, CRP, and the soluble TNF receptors.…”