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. 2024 Jun;71(6):e30951.
doi: 10.1002/pbc.30951. Epub 2024 Mar 31.

Different subtypes of chronic fatigue in childhood cancer survivors: A DCCSS LATER study

Adriaan Penson  1 , Iris Walraven  2 , Ewald Bronkhorst  2 , Martha A Grootenhuis  3 , Heleen Maurice-Stam  3 , Margriet van der Heiden-van der Loo  3 , Wim J E Tissing  3   4 , Helena J H van der Pal  3 , Andrica C H de Vries  5 , Dorine Bresters  3 , Cécile M Ronckers  3   6 , Marry M van den Heuvel-Eibrink  3   5 , Sebastian Neggers  3   7 , Birgitta A B Versluys  3 , Marloes Louwerens  8 , Saskia M F Pluijm  3 , Nicole Blijlevens  1 , Eline van Dulmen-den Broeder  9 , Leontien C M Kremer  3   10 , Hans Knoop  11 , Jacqueline Loonen  1 ; Dutch LATER study group
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Different subtypes of chronic fatigue in childhood cancer survivors: A DCCSS LATER study

Adriaan Penson et al. Pediatr Blood Cancer. 2024 Jun.

Abstract

Introduction: The aim of the current study was to investigate whether subtypes of chronic fatigue (CF) can be identified in childhood cancer survivors (CCS), and if so, to determine the characteristics of participants with a specific subtype.

Methods: Participants were included from the nationwide DCCSS LATER cohort. The Checklist Individual Strength (CIS) was completed to assess fatigue. Participants with CF (scored ≥35 on the fatigue severity subscale and indicated to suffer from fatigue for ≥6 months) were divided into subgroups using two-step cluster analysis based on the CIS concentration, motivation, and physical activity subscales. Differences between groups on demographics, psychosocial, lifestyle, and treatment-related variables were determined using ANOVA and chi-square analyses (univariable) and multinomial regression analysis (multivariable).

Results: A total of 1910 participants participated in the current study (n = 450 with CF; n = 1460 without CF). Three CF subgroups were identified: Subgroup 1 (n = 133, 29% of participants) had CF with problems in physical activity; Subgroup 2 (n = 111, 25% of participants) had CF with difficulty concentrating; and Subgroup 3 (n = 206, 46% of participants) had multi-dimensional CF. Compared to Subgroup 1, Subgroup 2 more often reported sleep problems, limitations in social functioning, and less often have more than two comorbidities. Subgroup 3 more often reported depression, sleep problems, a lower self-esteem, and limitations in social functioning and a lower educational level compared to Subgroup 1.

Conclusion: Different subgroups of CCS with CF can be identified based on fatigue dimensions physical activity, motivation and concentration. Results suggest that different intervention strategies, tailored for each subgroup, might be beneficial.

Keywords: childhood cancer survivors; chronic fatigue; fatigue severity; mental fatigue; physical fatigue; subgroup analyses.

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References

REFERENCES

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