Clinically Significant Fatigue in Adult Leukemia Patients: Prevalence, Predictors, and Impact on Quality of Life

Isamme AlFayyad, Mohamad Al-Tannir, Muawiyah Yaqub, Humariyah Heena, Nawaf AlMukaibil, Mohammed Ghazwani, Amani Abu-Shaheen, Isamme AlFayyad, Mohamad Al-Tannir, Muawiyah Yaqub, Humariyah Heena, Nawaf AlMukaibil, Mohammed Ghazwani, Amani Abu-Shaheen

Abstract

Background Cancer-related fatigue (CRF) is a common distressing symptom in leukemia patients. CRF becomes clinically significant fatigue (CSF) when adversely affects health-related quality of life (HRQoL) and warrants further workup, referrals, and treatment. Objective: To assess the prevalence and predictors of CSF and assesses its impact on HRQoL in adult leukemia patients. Method Analysis was performed on 168 leukemia patients. The primary study outcomes were CSF (score ≥4) as measured by the fatigue numerical rating scale and HRQoL using a validated Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu) scale. Result The prevalence of CSF was 89 (53%), with a mean score of 6.66±2.02. About 106 (63.1%) of leukemia patients had poor Health-related quality of life (HRQoL) (102.61±23.50). Overall, FACT-Leu mean score indicated that study participants had poor HRQoL (114.70±29.67). There was a statistically significant difference in HRQoL between the patients with CSF 104.89±28.82 and Non-CSF 125.76±26.71, p<0.001. Poor appetite (odd ratio: 3.02 [95% CI: 1.33-6.85]) was statistically significant predictors (p<0.010) of CSF. Dependence on caregiver (odd ratio: 3.31 [95% CI: 0.41-0.75]) and having non-CSF (odd ratio: 5.22 [95% CI: 2.44-11.19]) were found statistically significant predictors of good HRQoL. Conclusion CSF is prevalent among leukemia patients, and adversely affects their HRQoL. Holistic assessment and supportive care are needed to reduce the burden of CSF and improve leukemia patients HRQoL.

Keywords: adults; cancer; clinically significant fatigue; leukemia; quality of life (qol).

Conflict of interest statement

The authors have declared that no competing interests exist.

Copyright © 2020, AlFayyad et al.

Figures

Figure 1. Receiver operating characteristic curve for…
Figure 1. Receiver operating characteristic curve for FACT-Leu scale.
FACT-Leu- Functional Assessment of Cancer Therapy-Leukemia; ROC curve- receiver operating characteristic curve; CI- Confidence interval

References

    1. Comparison of pharmaceutical, psychological, and exercise treatments for cancer-related fatigue: a meta-analysis. Mustian KM, Alfano CM, Heckler C, et al. JAMA Oncol. 2017;1:961–968.
    1. Screening, evaluation, and management of cancer‐related fatigue: ready for implementation to practice? Berger AM, Mitchell SA, Jacobsen PB, Pirl WF. CA Cancer J Clin. 2015;65:190–211.
    1. Symptom prevalence in patients with incurable cancer: a systematic review. Teunissen SC, Wesker W, Kruitwagen C, De Haes HC, Voest EE, De Graeff A. J Pain Symptom Manage. 2007;34:94–104.
    1. Single institute experience with methylphenidate and American ginseng in cancer-related fatigue. Chang YD, Smith J, Portman D, Kim R, Oberoi-Jassal R, Rajasekhara S, Davis M. Am J Hosp Palliat Care. 2018;35:144–150.
    1. A systematic review of research using the diagnostic criteria for cancer‐related fatigue. Donovan KA, McGinty HL, Jacobsen PB. Psychooncology. 2013;22:737–744.
    1. Evaluation of screening instruments for cancer-related fatigue syndrome in breast cancer survivors. Alexander S, Minton O, Stone PC. J Clin Oncol. 2009;27:1197–1201.
    1. Fatigue in cancer patients during and after treatment: prevalence, correlates and interventions. Servaes P, Verhagen C, Bleijenberg G. Eur J Cancer. 2002;38:27–43.
    1. Is cancer-related fatigue more strongly correlated to haematological or to psychological factors in cancer patients? Romito F, Montanaro R, Corvasce C, Di Bisceglie M, Mattioli V. Support Care Cancer. 2008;16:943–946.
    1. Prevalence and predictors of fatigue in haemo‐oncological patients. Zordan R, Manitta V, Nandurkar H, Cole‐Sinclair M, Philip J. J. Intern. Med. 2014;44:1013–1017.
    1. Prevalence and characteristics of moderate to severe fatigue: a multicenter study in cancer patients and survivors. Wang XS, Zhao F, Fisch MJ, O'Mara AM, Cella D, Mendoza TR, Cleeland CS. Cancer. 2014 ;120:425–432.
    1. NCCN Practice guidelines for cancer-related fatigue. Mock V, Atkinson A, Barsevick A, et al. Oncology. 2000;14:151–161.
    1. Cancer-related fatigue—mechanisms, risk factors, and treatments. Bower JE. Nat Rev Clin Oncol. 2014;11:597.
    1. ADVANCE-advance care planning; an innovative palliative care intervention to improve quality of life in cancer patients-a multi-centre cluster randomized clinical trial-fp7 project. Korfage I, Rietjens Rietjens, J. Van der Heide A. Impact. 2017; 4:37–39.
    1. Cancer-related fatigue: impact on patient quality of life and management approaches. Yeo TP, Cannaday S. Nursing: research and reviews. 2015;5:65.
    1. International perspective on health-related quality-of-life research in cancer clinical trials: the European organisation for research and treatment of cancer experience. Bottomley A, Aaronson NK. J Clin Oncol. 2007 ;25:5082–5086.
    1. Factors predicting clinically significant fatigue in women following treatment for primary breast cancer. Gerber LH, Stout N, McGarvey C, et al. Support Care Cancer. 2011;19:1581–1591.
    1. Measuring health-related quality of life in leukemia: the functional assessment of cancer therapy-leukemia (FACT-Leu) questionnaire. Cella D, Jensen SE, Webster K, et al. Value Health. 2012;15:1051–1058.
    1. Multidimensional independent predictors of cancer-related fatigue. Hwang SS, Chang VT, Rue M, Kasimis B. J Pain Symptom Manage. 2003;26:604–614.
    1. Factors affecting quality of life and fatigue in patients with leukemia under chemotherapy. Musarezaie A, Khaledi F, Esfahani HN, Ghaleghasemi TM. J Educ Health Promot. 2014;3:64.
    1. Fatigue in older adults with acute myeloid leukemia: predictors and associations with quality of life and functional status. Alibhai SM, Leach M, Kowgier ME, Tomlinson GA, Brandwein JM, Minden MD. Leukemia. 2007;21:845–848.
    1. Clinical factors associated with cancer-related fatigue in patients being treated for leukemia and non-Hodgkin’s lymphoma. Wang XS, Giralt SA, Mendoza TR, et al. J Clin Oncol. 2002;20:1319–1328.
    1. Sleep disturbance among patients with myelodysplastic syndromes and acute leukemia. Luskin M, Zhou E, Zhang Z, et al. Blood. 2019:4786.
    1. Clinical factors associated with fatigue in haematologic cancer patients receiving stem-cell transplantation. Prieto JM, Blanch J, Atala J, Carreras E, Rovira M, Cirera E, Gastó C. Eur J Cancer. 2006;42:1749–1755.
    1. Arcasoy MO. Anemia. Vol. 3. UK: Cambridge University Press; 2018 . Anemia in the Patient with Cancer; p. 172.
    1. Assessment of cancer-related fatigue among cancer patients receiving various therapies: a cross-sectional observational study. Banipal RP, Singh H, Singh B. Indian J Palliat Care. 2017;23:207.
    1. A real-world, cross-sectional, community survey of symptoms and health-related quality of life of adults with acute myeloid leukemia. Mamolo C, Cappelleri J, Hoang C, et al. Future Oncol. 2019;15:1895–1909.
    1. Symptom management and psychosocial needs of adults with acute myeloid leukemia during induction treatment: a pilot study. Albrecht TA, Boyiadzis M, Elswick Jr RK, Starkweather A, Rosenzweig M. Cancer nursing. 2017;40:0.
    1. Treatment choices: a quality of life comparison in acute myeloid leukemia and high-risk myelodysplastic syndrome. Tinsley SM, Sutton SK, Thapa R, Lancet J, McMillan SC. Clin Lymphoma Myeloma Leuk. 2017;17:0–9.
    1. The impact of remission status on patients’ experiences with acute myeloid leukemia (AML): an exploratory analysis of longitudinal patient-reported outcomes data. Kayastha N, Wolf SP, Locke SC, Samsa GP, El-Jawahri A, LeBlanc TW. Support Care Cancer. 2018;26:1437–1445.
    1. Quality of life beyond 6 months after diagnosis in older adults with acute myeloid leukemia. Alibhai SM, Leach M, Gupta V, Tomlinson GA, Brandwein JM, Saiz FS, Minden MD. Crit Rev Oncol Hematol. 2009;69:168–174.

Source: PubMed

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