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. 2016 May;51(5):705-12.
doi: 10.1038/bmt.2015.320. Epub 2016 Feb 1.

Prevalence and determinants of fatigue in patients with moderate to severe chronic GvHD

A Im  1 , S A Mitchell  2 , S M Steinberg  3 , L Curtis  4 , A Berger  5 , K Baird  6 , Z Kuzmina  7 , G Joe  8 , L E Comis  8 , M Juckett  9 , D Avila  4 , J Baruffaldi  10 , L Masuch  4 , F Pirsl  4 , S Z Pavletic  4
Affiliations

Prevalence and determinants of fatigue in patients with moderate to severe chronic GvHD

A Im et al. Bone Marrow Transplant. 2016 May.

Abstract

Although fatigue is common after allogeneic hematopoietic cell transplantation, little is known about fatigue in patients with chronic GvHD (cGvHD). The aim of this study was to explore factors associated with fatigue in cGvHD. Data were drawn from a sequentially recruited, cross-sectional study of adults with moderate or severe cGvHD (n=263). Respondents were classified as fatigued or not fatigued based on their response to a single item regarding loss of energy from the Lee cGvHD Symptom Scale. In univariate analysis, factors significantly associated with fatigue included performance status, number of prior cGvHD therapies, cGvHD symptom bother, self-assessed physical and mental health, nutritional status, walk velocity and self-reported physical activity. There were no significant associations between fatigue and disease-related cGvHD variables. Multivariable logistic regression demonstrated that being less active and having pulmonary and/or muscle/joint symptoms were independently associated with fatigue. In conclusion, clinically significant fatigue was prevalent in more than one-third of subjects with cGvHD, and was disabling. Absence of association with measures of cGvHD severity underscores the need to elucidate the pathogenesis of fatigue and its relationship with inflammatory activity. Pulmonary and muscle/joint symptoms and physical inactivity represent potential targets for intervention in clinical studies.

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Conflict of interest statement

CONFLICT OF INTEREST

The authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
SF 36 PCS score, SF 36 MCS score, and vitality subscale score in fatigued vs. not fatigued patients.
See this image and copyright information in PMC

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