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26.11.2018 | Original Article

Severely bothersome fatigue in children and adolescents with cancer and hematopoietic stem cell transplant recipients

Zeitschrift:
Supportive Care in Cancer
Autoren:
Deborah Tomlinson, Christina Baggott, David Dix, Paul Gibson, Shannon Hyslop, Donna L. Johnston, Andrea Orsey, Carol Portwine, Victoria Price, Magimairajan Vanan, Susan Kuczynski, Brenda Spiegler, George A. Tomlinson, L. Lee Dupuis, Lillian Sung

Abstract

Background

Objectives were to describe bothersome fatigue in children with cancer and hematopoietic stem cell (HSCT) recipients and to identify factors associated with severely bothersome fatigue.

Methods

We included children ages 8–18 years treated for cancer or HSCT recipients from three groups: [1] receiving active cancer treatment and admitted to hospital for at least 3 days, [2] attending outpatient clinic for acute lymphoblastic leukemia maintenance therapy, and [3] attending outpatient clinic following treatment completion. Fatigue was measured using the Symptom Screening in Pediatrics Tool (SSPedi); severely bothersome fatigue was defined as a lot or extremely bothersome fatigue (score of 3–4 on 0–4 scale). Factors associated with severely bothersome fatigue were examined using univariate and multiple logistic regression.

Results

Of 502 children included, 414 (82.5%) reported some degree of bothersome fatigue (scores 1–4), and 123 (24.5%) reported severely bothersome fatigue (score 3 or 4). In multiple regression analysis, factors significantly associated with severely bothersome fatigue were child age 11–14 and 15–18 years vs 8–10 years (odds ratio (OR) 2.11, 95% confidence interval (CI) 1.21–3.77 and OR 2.96, 95% CI 1.66–5.44), and inpatients receiving cancer treatment vs outpatients who had completed therapy (OR 3.85, 95% CI 2.17–7.27).

Conclusions

We found that 82.5% of children with cancer or HSCT recipients reported bothersome fatigue and 24.5% of children reported severely bothersome fatigue. Risk factors for severely bothersome fatigue were older age and inpatients receiving active cancer treatment. Future work should evaluate systematic symptom screening in clinical practice and apply interventions to reduce fatigue.

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