Investigating the temporal course, relevance and risk factors of fatigue over 5 years: a prospective study among patients receiving allogeneic HSCT

    loading  Checking for direct PDF access through Ovid

Abstract

Although allogeneic hematopoietic stem cell transplantation (HSCT) features severe physical and psychological strain, no previous study has prospectively investigated fatigue beyond 3 years after transplantation. We investigated the temporal course of fatigue over 5 years, compared patients with the general population (GP) and tested for treatment- and complication-related risk factors. Patients were assessed before conditioning (T0, N = 239) and at 100-day (T1, N = 150), 1-year (T2, N = 102) and 5-year (T3, N = 45) follow-up. We measured fatigue with the Multidimensional Fatigue Inventory-20. Patients were compared with the GP at T0 and at T3. Global fatigue increased from T0 to T1 (t = 3.85, P<0.001), decreased from T1 to T2 (t = -2. 92, P = 0.004) and then remained stable (t = 0.45, P = 0.656). No difference in global fatigue was found between T0 and T3 (t = 0.68, P = 0.497). Compared with the GP, patients showed higher global fatigue at T0 (t = - 6.02, P< 0.001) and T3 (t = -2.50, P = 0.014). These differences reached meaningful effect sizes (d≥0.5). Acute and chronic GvHD predicted global fatigue at T1 (γ=0.34, P = 0.006) and T2 (γ = 0.38, P = 0.010), respectively. To conclude, fatigue among allogeneic HSCT patients improves with time, finally returning to pretransplantation levels. However, even after 5 years, the difference from the GP remains relevant. Patients with GvHD are at risk for increased fatigue.

Related Topics

    loading  Loading Related Articles