Persistent fatigue in hematopoietic stem cell transplantation survivors
Open accessAbstract
Background: Fatigue is highly prevalent after hematopoietic stem cell transplantation (HCT). It has been described as intense and may last for years following treatment. Objective: The aim of this study is to compare fatigue, physical activity, sleep, emotional distress, cognitive function, and biological measures in HCT survivors with persistent fatigue (n = 25) with age- and gender-matched healthy controls with occasional tiredness (n = 25). Methods: Data were collected using (a) objective, real-time assessments of physical activity and sleep over 7 days; (b) patient-reported fatigue assessments; (c) computerized objective testing of cognitive functioning; and (d) biological measures. Differences between groups were examined using multivariate analysis of variance. Results: Survivors of HCT reported increased physical (P < .001), mental (P < .001), and overall (P < .001) fatigue as well as increased anxiety (P < .05) and depression (P < .01) compared with healthy controls. Red blood cell (RBC) levels were significantly lower in HCT survivors (P < .001). Levels of RBC for both groups, however, were in the normal range. Tumor necrosis factor-α (P < .001) and interleukin-6 (P < .05) levels were significantly higher in HCT survivors. Conclusions: Persistent fatigue in HCT survivors compared with healthy controls with occasional tiredness is accompanied by increased anxiety and depression along with decreased RBC counts. Elevated tumor necrosis factor-α and interleukin-6 levels may be important biomarkers. Implications for Practice: This study provides preliminary support for the conceptualization of fatigue as existing on a continuum, with tiredness anchoring one end and exhaustion the other. Persistent fatigue experienced by HCT survivors is more severe than the occasional tiredness of everyday life.
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Treatment-related side effects such as fatigue and debility can persist for months or even years after HSCT.
“Treatment-related side effects such as fatigue and debility can persist for months or even years [2-4]”
From Mindfulness, Experiential Avoidance, and Recovery From Hematopoietic Stem Cell Transplantation. (2019) · cites this paper as [3]
The Introduction and Abstract Background state that fatigue after HCT can persist for years, supporting the duration claimed. The paper does not establish debility as a separate persistent treatment-related side effect. (LLM, conf=0.85)
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Cites
The Hospital Anxiety and Depression Scale
Zigmond, A. S., & Snaith, R. P. (1983) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1983.tb09716.x · Cited by 47,139 · see citing works
Depression and quality of life in older persons: A review
Sivertsen, H., Bjørkløf, G. H., Engedal, K., Selbæk, G., & Helvik, A.-S. (2015) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000437299 · Cited by 14,152 · see citing works
Cella, D., Riley, W., Stone, A., Rothrock, N., Reeve, B., Yount, S., Amtmann, D., Bode, R., Buysse, D., Choi, S., et al. (2010) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2010.04.011 · Cited by 5,128 · see citing works
Development of a fatigue scale
Chalder, T., Berelowitz, G., Pawlikowska, T., Watts, L., Wessely, S., Wright, D., & Wallace, E. P. (1993) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(93)90081-p · Cited by 3,032 · see citing works
The Role of Actigraphy in the Study of Sleep and Circadian Rhythms
Ancoli-Israel, S., Cole, R., Alessi, C., Chambers, M., Moorcroft, W., & Pollak, C. P. (2003) · Sleep · doi:10.1093/sleep/26.3.342 · Cited by 2,751 · see citing works
Pilkonis, P. A., Choi, S. W., Reise, S. P., Stover, A. M., Riley, W. T., Cella, D., & PROMIS Cooperative Group (2011) · Assessment · doi:10.1177/1073191111411667 · Cited by 2,132 · see citing works
Post-Stroke Fatigue: Epidemiology, Clinical Characteristics and Treatment
Acciarresi, M., Bogousslavsky, J., & Paciaroni, M. (2014) · European Neurology · doi:10.1159/000363763 · Cited by 1,423 · see citing works
Marino, M., Li, Y., Rueschman, M. N., Winkelman, J. W., Ellenbogen, J. M., Solet, J. M., Dulin, H., Berkman, L. F., & Buxton, O. M. (2013) · Sleep · doi:10.5665/sleep.3142 · Cited by 1,056 · see citing works
Reliability and validity of a computerized neurocognitive test battery, CNS vital signs
GUALTIERI, C., & JOHNSON, L. (2006) · Archives of Clinical Neuropsychology · doi:10.1016/j.acn.2006.05.007 · Cited by 873 · see citing works
Buysse, D. J., Yu, L., Moul, D. E., Germain, A., Stover, A., Dodds, N. E., Johnston, K. L., Shablesky-Cade, M. A., & Pilkonis, P. A. (2010) · Sleep · doi:10.1093/sleep/33.6.781 · Cited by 850 · see citing works
Evaluation of Item Candidates: The PROMIS Qualitative Item Review
DeWalt, D. A., Rothrock, N., Yount, S., & Stone, A. A. (2007) · Medical Care · doi:10.1097/01.mlr.0000254567.79743.e2 · Cited by 719 · see citing works
Fatigue in long‐term breast carcinoma survivors
Bower, J. E., Ganz, P. A., Desmond, K. A., Bernaards, C. A., Rowland, J. H., Meyerowitz, B. E., & Belin, T. R. (2006) · Cancer · doi:10.1002/cncr.21671 · Cited by 694 · see citing works
Fatigue in the general norwegian population
Loge, J. H., Ekeberg, Ø., & Kaasa, S. (1998) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(97)00291-2 · Cited by 594 · see citing works
Bower, J. E., Ganz, P. A., Irwin, M. R., Kwan, L. C., Breen, E. C., & Cole, S. W. (2011) · Journal of Clinical Oncology · doi:10.1200/jco.2011.36.1154 · Cited by 490 · see citing works
Behavioral Symptoms in Patients With Breast Cancer and Survivors
Bower, J. E. (2008) · Journal of Clinical Oncology · doi:10.1200/jco.2007.14.3248 · Cited by 488 · see citing works
Garcia, S. F., Cella, D., Clauser, S. B., Flynn, K. E., Lad, T., Lai, J.-S., Reeve, B. B., Wilder Smith, A., Stone, A. A., & Weinfurt, K. (2007) · Journal of Clinical Oncology · doi:10.1200/jco.2007.12.2341 · Cited by 407 · see citing works
Measuring fatigue in clinical and community settings
Cella, M., & Chalder, T. (2009) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2009.10.007 · Cited by 380 · see citing works
Duijts, S. F. A., van Egmond, M. P., Spelten, E., van Muijen, P., Anema, J. R., & van der Beek, A. J. (2014) · Psycho-Oncology · doi:10.1002/pon.3467 · Cited by 356 · see citing works
Rothrock, N. E., Hays, R. D., Spritzer, K. L., Yount, S., Riley, W. T., & Cella, D. F. (2010) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2010.04.012 · Cited by 351 · see citing works
Andrykowski, M. A., Bishop, M. M., Hahn, E. A., Cella, D. F., Beaumont, J. L., Brady, M. J., Horowitz, M. M., Sobocinski, K. A., Rizzo, J. D., & Wingard, J. R. (2005) · Journal of Clinical Oncology · doi:10.1200/jco.2005.03.189 · Cited by 320 · see citing works
Mosher, C. E., Redd, W. H., Rini, C. M., Burkhalter, J. E., & DuHamel, K. N. (2009) · Psycho-Oncology · doi:10.1002/pon.1399 · Cited by 315 · see citing works
Berger, A. M., Abernethy, A. P., Atkinson, A., Barsevick, A. M., BREITBART, W. S., Cella, D. F., Cimprich, B., Cleeland, C. S., Eisenberger, M. A., Escalante, C. P., et al. (2010) · Journal of the National Comprehensive Cancer Network · doi:10.6004/jnccn.2010.0067 · Cited by 295 · see citing works
Quantitating Physical Activity in COPD Using a Triaxial Accelerometer
Steele, B. G., Holt, L., Belza, B. L., Ferris, S. T., Lakshminaryan, S., & Büchner, D. M. (2000) · CHEST Journal · doi:10.1378/chest.117.5.1359 · Cited by 289 · see citing works
Cancer-related fatigue: Links with inflammation in cancer patients and survivors
Bower, J. E. (2007) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2007.03.013 · Cited by 256 · see citing works
Technical Reliability Assessment of Three Accelerometer Models in a Mechanical Setup
Esliger, D., & Tremblay, M. S. (2006) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000239394.55461.08 · Cited by 244 · see citing works
Hodgkin's Disease Survivors More Fatigued Than the General Population
Loge, J. H., Abrahamsen, A. F., Ekeberg, Ø., & Kaasa, S. (1999) · Journal of Clinical Oncology · doi:10.1200/jco.1999.17.1.253 · Cited by 199 · see citing works
Bishop, M. M., Beaumont, J. L., Hahn, E. A., Cella, D. F., Andrykowski, M. A., Brady, M. J., Horowitz, M. M., Sobocinski, K. A., Rizzo, J. D., & Wingard, J. R. (2007) · Journal of Clinical Oncology · doi:10.1200/jco.2006.07.5705 · Cited by 197 · see citing works
Alexander, S. B., Minton, O., Andrews, P. L. R., & Stone, P. C. (2008) · European Journal of Cancer · doi:10.1016/j.ejca.2008.09.010 · Cited by 167 · see citing works
Hjermstad, M. J., Knobel, H., Brinch, L., Fayers, P. M., Loge, J. H., Holte, H., & Kaasa, S. (2004) · Bone Marrow Transplantation · doi:10.1038/sj.bmt.1704561 · Cited by 166 · see citing works
Prevalence and course of fatigue in breast cancer patients receiving adjuvant chemotherapy
de Jong, N., Candel, M. J. J. M., Schouten, H. C., Abu‐Saad, H. H., & Courtens, A. M. (2004) · Annals of Oncology · doi:10.1093/annonc/mdh229 · Cited by 163 · see citing works
Recommendations for High-Priority Research on Cancer-Related Fatigue in Children and Adults
Barsevick, A. M., Irwin, M. R., Hinds, P. S., Miller, A. H., Berger, A. M., Jacobsen, P. B., Ancoli‐Israel, S., Reeve, B. B., Mustian, K. M., O’Mara, A. M., et al. (2013) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djt242 · Cited by 158 · see citing works
Grulke, N., Albani, C., & Bailer, H. (2011) · Bone Marrow Transplantation · doi:10.1038/bmt.2011.107 · Cited by 151 · see citing works
Fatigue and Physical Activity in Patients Undergoing Hematopoietic Stem Cell Transplant
Hacker, E. D., Ferrans, C. E., Verlen, E., Ravandi, F., van Besien, K., Gelms, J., & Dieterle, N. (2006) · Oncology nursing forum · doi:10.1188/06.onf.614-624 · Cited by 150 · see citing works
Self-citationServaes, P., van der Werf, S. P., Prins, J. B., Verhagen, S. C. A. H. H. V. M., & Bleijenberg, G. (2001) · Supportive Care in Cancer · doi:10.1007/s005200000165 · Cited by 145 · see citing works
Harder, H., Cornelissen, J. J., Gool, A. R. V., Duivenvoorden, H. J., Eijkenboom, W. M. H., & van den Bent, M. J. (2002) · Cancer · doi:10.1002/cncr.10627 · Cited by 143 · see citing works
Routine screening for psychosocial distress following hematopoietic stem cell transplantation
Lee, S. J., Loberiza, F. R., Antin, J. H., Kirkpatrick, T., Prokop, L. J., Alyea, E. P., Cutler, C. S., Ho, V. T., Richardson, P. G. G., Schlossman, R. L., et al. (2004) · Bone Marrow Transplantation · doi:10.1038/sj.bmt.1704709 · Cited by 142 · see citing works
Differences in fatigue by treatment methods in women with breast cancer.
Woo, B., Dibble, S. L., Piper, B. F., Keating, S., & Weiss, M. C. (1998) · PubMed · Cited by 139 · see citing works
Mitchell, S. A., Hoffman, A. J., Clark, J. C., DeGennaro, R., Poirier, P., Robinson, C. B., & Weisbrod, B. L. (2014) · Clinical journal of oncology nursing · doi:10.1188/14.cjon.s3.38-58 · Cited by 131 · see citing works
Goedendorp, M. M., Gielissen, M. F. M., Verhagen, C. A. H. H. V. M., & Bleijenberg, G. (2012) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2012.02.009 · Cited by 127 · see citing works
Cytokine Genetic Variations and Fatigue Among Patients With Breast Cancer
Bower, J. E., Ganz, P. A., Irwin, M. R., Castellon, S. A., Arevalo, J. M. G., & Cole, S. W. (2013) · Journal of Clinical Oncology · doi:10.1200/jco.2012.46.2143 · Cited by 121 · see citing works
Neuropsychological functioning in chronic fatigue syndrome: a review
Michiels, V., & Cluydts, R. (2001) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.2001.00017.x · Cited by 113 · see citing works
Jacobs, S. R., Jacobsen, P. B., Booth‐Jones, M., Wagner, L. I., & Anasetti, C. (2006) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2006.06.011 · Cited by 109 · see citing works
Physical Activity in Ovarian Cancer Survivors
Stevinson, C. D., Steed, H. L., Faught, W., Tonkin, K. S., Vallance, J. K., Ladha, A. B., Schepansky, A., Capstick, V. A., & Courneya, K. S. (2009) · International Journal of Gynecological Cancer · doi:10.1111/igc.0b013e31819902ec · Cited by 102 · see citing works
Fatigue after treatment for malignant and benign bone and soft tissue tumors
Servaes, P., Verhagen, S. C. A. H. H. V. M., Schreuder, H. W. B., Veth, R. P. H., & Bleijenberg, G. (2003) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2003.03.001 · Cited by 97 · see citing works
A New Way of Thinking About Fatigue: A Reconceptualization
Olson, K. L. (2007) · Oncology nursing forum · doi:10.1188/07.onf.93-99 · Cited by 95 · see citing works
Energy level and sleep quality following bone marrow transplantation
Andrykowski, M., Carpenter, J. S., Greiner, C. B., Altmaier, E., Burish, T. G., Antin, J. H., Gingrich, R., Cordova, M. J., & Henslee‐Downey, P. J. (1997) · Bone Marrow Transplantation · doi:10.1038/sj.bmt.1700949 · Cited by 92 · see citing works
Psychological distress in long‐term survivors of hematopoietic stem cell transplantation
Rusiewicz, A., DuHamel, K. N., Burkhalter, J. E., Ostroff, J. S., Winkel, G. H., Scigliano, E., Papadopoulos, E. B., Moskowitz, C. H., & Redd, W. H. (2007) · Psycho-Oncology · doi:10.1002/pon.1221 · Cited by 87 · see citing works
Wang, X. S., Shi, Q., Williams, L., Cleeland, C. S., Mobley, G. M., Reuben, J. M., Lee, B.-N., & Giralt, S. A. (2008) · Cancer · doi:10.1002/cncr.23820 · Cited by 77 · see citing works
Dean, G. E., Sabbah, E. A., Yingrengreung, S., Ziegler, P., Chen, H., Steinbrenner, L. M., & Dickerson, S. S. (2014) · Cancer Nursing · doi:10.1097/ncc.0000000000000128 · Cited by 75 · see citing works
Conner-Spady, B. L., Cumming, C. E., Jm, N., Jacobs, P., & Stewart, D. A. (2005) · Bone Marrow Transplantation · doi:10.1038/sj.bmt.1705032 · Cited by 62 · see citing works
Lynch, B. M., Cerin, E., Newman, B. M., & Owen, N. G. (2007) · Annals of Behavioral Medicine · doi:10.1007/bf02872668 · Cited by 62 · see citing works
Fatigue, Inflammation, and Projected Mortality in Heart Failure
Fink, A. M., Gonzalez, R. C., Lisowski, T., Pini, M., Fantuzzi, G., Levy, W. C., & Piano, M. R. (2012) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2012.07.003 · Cited by 54 · see citing works
Self-citationAltara, R., Manca, M., Hermans, K. C. M., et al. (2015) · Journal of Translational Medicine · doi:10.1186/s12967-015-0477-1 · Cited by 53 · see citing works
Psychosocial Function After Hematopoietic Stem Cell Transplantation
Chang, G., Orav, E. J., Mcnamara, T. K., Tong, M., & Antin, J. H. (2005) · Psychosomatics · doi:10.1176/appi.psy.46.1.34 · Cited by 35 · see citing works
Guðmundsson, A., Ershler, W. B., Goodman, B., Lent, S. J., Barczi, S. R., & Carnes, M. L. (1997) · Clinical Chemistry · doi:10.1093/clinchem/43.11.2199 · Cited by 33 · see citing works
Survivorship: Fatigue, Version 1.2014
Denlinger, C. S., Ligibel, J. A., Are, M., Baker, K. S., Demark‐Wahnefried, W., Friedman, D. L., Goldman, M. E., Jones, L. W., King, A. A., Ku, G., et al. (2014) · Journal of the National Comprehensive Cancer Network · doi:10.6004/jnccn.2014.0082 · Cited by 29 · see citing works
Experience of severe fatigue in long-term survivors of stem cell transplantation
Gielissen, M. F. M., Schattenberg, A. V. M., Verhagen, C. A. H. H. V. M., Rinkes, M. J., Bremmers, M. E. J., & Bleijenberg, G. (2007) · Bone Marrow Transplantation · doi:10.1038/sj.bmt.1705624 · Cited by 1 · cited 9× · see citing works
“Abbreviations: CRP, C-reactive protein; HADS, Hospital Anxiety and Depression Scale; HCT, hematopoietic stem cell transplantation ; IL-6, interleukin-6; NS, no significant differences between HCT survivors and healthy controls; PROMIS, Patient Reported Outcomes Measurement Information System; RBC, red blood cell; TNF-…”
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Research works printed but not linked: 1
- [20]Alexander S Minton O Andrews P Stone P A comparison of the characteristics of disease-free breast cancer survivors with or without cancer-related fatigue syndrome. Eur. J. Cancer 2009 45 3 384 392 18977131 PMC2653618
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Mindfulness, Experiential Avoidance, and Recovery From Hematopoietic Stem Cell Transplantation.
Larson, A. G., Morris, K. J., Juckett, M. B., Coe, C. L., Broman, A. T., & Costanzo, E. S. (2019) · Annals of Behavioral Medicine · doi:10.1093/abm/kay097 · Cited by 27 · see citing works
- Authors
- Hacker, E. D., Fink, A. M., Peters, T., Park, C., Fantuzzi, G., & Rondelli, D.
- Affiliations
- University of Illinois Chicago (US)
- Corresponding author
- Hacker, Eileen Danaher
- Venue
- Cancer Nursing
- Published
- 2017-05
- Volume
- 40
- Issue
- 3
- Pages
- 174-183
- ISSN
- 0162-220X (ISSN-L)
- 1538-9804
- PMC
- PMC5177539
- OpenAlex
- W2462401297
- Semantic Scholar
- 0a6ca44d1a86799bb3017a4bb6f73f5492c5fe0f
- Cited by
- 37
- References
- 57
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 3 · 2023: 5 · 2022: 5 · 2021: 6 · 2020: 1 · 2019: 3 · 2018: 3 · 2017: 1 · 2016: 1
- FWCI
- 1.44
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cancer Nursing (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000050)
- National Cancer Institute (UG1CA189823, U10CA037447, U10CA180821)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Keywords
- persistent fatigue, hematopoietic stem cell transplantation, transplant survivors, physical activity, sleep, anxiety, depression, cognitive function, red blood cell count, TNF-α, interleukin-6, biomarkers
- MeSH terms
- Adult, Fatigue, Female, Humans, Male, Middle Aged, Case-Control Studies, Survivors, Hematopoietic Stem Cell Transplantation
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