Prevalence, severity and correlates of fatigue in newly diagnosed patients with myelodysplastic syndromes

Abstract

SummaryThe primary objective of this study was to investigate factors associated with fatigue severity in newly diagnosed patients with higher-risk myelodysplastic syndromes (MDS). The secondary objectives were to assess symptom prevalence and to examine the relationships between fatigue, quality of life (QoL) and overall symptom burden in these patients. The analyses were conducted in 280 higher-risk MDS patients. Pre-treatment patient-reported fatigue was evaluated with the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue scale and QoL was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). Female gender (P = 0Á018), poor performance status (i.e., ECOG of 2-4) (P < 0Á001) and lower levels of haemoglobin (Hb) (P = 0Á026) were independently associated with higher fatigue severity. The three most prevalent symptoms were as follows: fatigue (92%), dyspnoea (63%) and pain (55%). Patients with higher levels of fatigue also had greater overall symptom burdens. The mean global QoL scores of patients with the highest versus those with the lowest levels of fatigue were 29Á2 [standard deviation (SD), 18Á3] and 69Á0 (SD, 18Á8), respectively and this difference was four times the magnitude of a clinically meaningful difference. Patient-reported fatigue severity revealed the effects of disease burden on overall QoL more accurately than did degree of anaemia. Special attention should be given to the female patients in the management of fatigue.

Prospective international validation of the Quality of Life in Myelodysplasia Scale (QUALMS)

“…[6][7][8] Indeed, patients with MDS suffer from a wide variety of symptoms including fatigue, anxiety, insomnia, and dyspnea. 9 It is essential to understand such patient-reported outcomes for their own value, and not just for their potential contribution to disease risk. Although an Internet-based survey of MDS patients' QOL has been published, 10 no MDS-specific QOL measure has been widely adopted for clinical or research use.…”

“…Although an Internet-based survey of MDS patients' QOL has been published, 10 no MDS-specific QOL measure has been widely adopted for clinical or research use. Researchers aiming to assess the impact of MDS and its treatments 9,[11][12][13][14][15][16][17][18] on QOL have most often used generic measures such as the Short-Form Health Survey (SF-36), 19 or cancer-specific scales such as the European Organization for Research and Treatment of Cancer's QLQ-C30 20 and the Functional Assessment of Cancer Therapy-Anemia (FACT-An). 21 While these measures are useful, they are not specific enough to contain all of the elements important to MDS-related QOL, and may contain several less relevant items.…”

Are chemotherapy-associated symptoms underestimated? A view beyond common toxicity criteria

“…Therefore, it is not unlikely that it is associated with other adverse events. Recently studies have reported that fatigue is associated with other common adverse events, such as CIPN, and greater levels of fatigue were associated with greater symptom severity [11,18,19]. Additional analysis of data of a previous study [12] showed significantly (p50.0001) more fatigue, measured by the total score of the fatigue assessment scale, in patients with the 10% highest CIPN scores (N ¼ 141, mean ¼ 25.38, SD ¼ 8.43) compared to those with lower CIPN scores (N ¼ 1348, mean ¼ 19.41, SD ¼ 5.84).…”

Effects of a home-based exercise program on physical capacity and fatigue in patients with low to intermediate risk myelodysplastic syndrome—a pilot study

“…The rationale for this study was the fact that fatigue by far is one of the most compromising symptoms in MDS [4]. In a recent study by Efficace and colleagues, more than 90% of patients experienced fatigue and 30% reported to have moderate to severe fatigue.…”

“…http Among others, fatigue is also the most prevalent and disabling patient reported outcome (PRO) as reported by more than 90% of patients [4]. Other symptoms like dyspnea, insomnia and pain affect more than half of the patients.…”