Persistent Fatigue in Hematopoietic Stem Cell Transplantation Survivors.
Eileen Danaher Hacker, Anne M Fink, Tara Peters and 3 others
PMID 27333126WHAT IT FOUND
Stem-cell transplant survivors with persistent fatigue reported more fatigue, anxiety, and depression than matched healthy controls.
Objective sleep, activity, and cognitive tests did not differ, but blood markers IL-6 and TNF-alpha were higher.
Key findings
01Stem-cell transplant survivors with persistent fatigue reported more fatigue, anxiety, and depression than healthy controls with occasional tiredness.
02Objective physical activity, sleep, and cognitive testing did not show significant differences between the groups, although survivors reported worse memory.
03Red blood cell levels were lower in survivors but within normal range, while IL-6 and TNF-alpha levels were higher than in controls.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a pilot study with only 25 survivors and 25 controls, so the findings may not hold in larger or more diverse groups. Participants self-identified as having persistent fatigue or occasional tiredness, and eligibility was self-reported without medical record verification. The study compared groups at one time point and did not test whether any treatment reduced fatigue or whether biomarkers cause fatigue. All survivors had to be disease-free for at least one year, able to walk without assistance, and free of major psychiatric, anxiety, depressive, or sleep disorders, so findings may not apply to more complex survivors. No third group of transplant survivors with occasional tiredness was included, so it is unclear whether differences are due to transplant, persistent fatigue, or survivor status.
Declared interests
No author conflicts of interest are stated in the article text. The publication types indicate NIH extramural research support.
The easy way to misread this
Do not use the elevated IL-6 and TNF-alpha findings to order inflammatory markers in routine survivorship care. This was a small pilot, and the study did not test whether these markers cause fatigue or respond to treatment.