Severe Fatigue in Stem Cell Transplantation
Condition: Stem Cell Transplantation; Fatigue
MeSH terms: Fatigue
Study type: Observational

Summary: 
      Fatigue is a common symptom during allogeneic-hematopoietic stem cell transplantation
      (allo-HSCT). However, effects of severe fatigue on pulmonary functions, blood cells, dyspnea,
      muscle strength, exercise capacity, depression and quality of life (QOL) in allo-HSCT
      recipients are still unknown.
    

Detailed description: 
      Fatigue is the most complained side effect that may last for months or even years after
      treatment ends in patients with cancer. Cancer-related fatigue is described as 'a
      distressing, persistent, subjective sense of physical, emotional and/or cognitive tiredness
      or exhaustion related to cancer or cancer treatment that is not proportional to recent
      activity and interferes with usual functioning'. The cancer-related fatigue observed in 80%
      of cancer patients received chemotherapy and/or radiotherapy, yet underlying mechanism of
      cancer-related fatigue is not still clearly explained.

      Hematological malignancy itself and its treatments including chemotherapy, radiotherapy,
      surgery, medical treatment and/or allogeneic or autologous hematopoietic stem cell
      transplantation cause lots of early and late adverse effects such as appetite loss, nausea
      and vomiting, diarrhea, fatigue, sleep disturbance, pain, cardiopulmonary and neuromuscular
      deconditioning, impairments in mobility, muscle weakness and increased risk of fall.

      Hematopoietic stem cells collected from bone marrow, peripheral blood or umbilical cord blood
      of healthy donors are infused into allogeneic hematopoietic stem cell transplantation
      (allogeneic-HSCT) recipients with hematological malignancy. Allogeneic-HSCT is highly
      associated with transplant-related mortality, morbidity, graft-versus host disease and
      another various complications. Because of the above-mentioned risks, recipients and their
      caregivers are required to remain close to transplant center in the acute phase of
      transplantation, approximately 100 days. As a consequence, hematopoietic stem cell
      transplantation has a negative impact on quality of life in recipients and their caregivers
      who report fatigue, sleep and sexual problems and emotional distress. Especially fatigue is a
      destructive symptom for recipients, exists before hematopoietic stem cell transplantation and
      further deteriorates during the first three weeks after hematopoietic stem cell
      transplantation. Moreover baseline fatigue severity continues until one year after
      hematopoietic stem cell transplantation.

      Although fatigue has been one of the most intensely experienced symptoms by allogeneic-HSCT
      recipients, no study has compared pulmonary functions, albumin-hemoglobin-white blood cell
      levels, dyspnea, respiratory and peripheral muscle strength, submaximal exercise capacity,
      depression and quality of life between severe-fatigued and non-severe-fatigued
      allogeneic-HSCT recipients, yet. Therefore investigators aimed to compare the effects of
      severe fatigue on aforementioned outcomes in recipients.
    

Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Forty-nine allogeneic-HSCT recipients who were at minimum 100 days status
        post-transplantation, between ages of 18 and 65, under standard medical treatment,
        transplanted at Bone Marrow Transplantation Unit of University Faculty of Medicine were
        included. Twenty four severe-fatigued (Fatigue Severity Scale score ≥36) and 25
        non-severe-fatigued recipients were compared.Study was approved by local Ethics Committee
        and informed consent was obtained from all individual participants included in study.
      
Keywords: stem cell transplantation; Fatigue; muscle strength; exercise capacity; Depression; Quality of Life