Differences in pulmonary and extra-pulmonary characteristics in severely versus non-severely fatigued recipients of allogeneic hematopoietic stem cell transplantation: a cross-sectional, comparative study

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Bargi G., Guclu M., Sucak A. G. T.

HEMATOLOGY, vol.24, no.1, pp.112-122, 2019 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 24 Issue: 1
  • Publication Date: 2019
  • Doi Number: 10.1080/10245332.2018.1526441
  • Journal Name: HEMATOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.112-122
  • Keywords: Depression, hematopoietic stem cell transplantation, fatigue, muscle strength, pulmonary function, respiratory muscles, quality of life, walk test, QUALITY-OF-LIFE, TERM-FOLLOW-UP, MULTIPLE-SCLEROSIS, MUSCLE STRENGTH, SEVERITY SCALE, RELIABILITY, GUIDELINES, SURVIVORS, SYMPTOMS, VALIDITY
  • Gazi University Affiliated: Yes


Objectives: Fatigue is a common symptom in allogeneic-hematopoietic stem cell transplantation (allogeneic-HSCT) recipients. However, effects of severe fatigue on pulmonary functions, blood cells, dyspnea, muscle strength, exercise capacity, depression and quality of life (QOL) in allogeneic-HSCT recipients are still unknown. Therefore, to compare pulmonary functions, blood levels, dyspnea, muscle strength, exercise capacity, depression, and QOL between allogeneic-HSCT recipients according to fatigue severity and to determine predictors of severe fatigue were aimed in the current study. Methods: Twenty-four severe-fatigued (Fatigue Severity Scale score >= 36) (40.08 +/- 12.44years) and 25 non-severe-fatigued (36.20 +/- 13.73years) allogeneic-HSCT recipients were compared. Blood levels, pulmonary functions (spirometer), dyspnea (Modified Medical Research Council Dyspnea scale), exercise capacity (6-minute walk test), depression (Beck Depression Inventory-II), QOL (European Organization for Research and Treatment of Cancer QOL Questionnaire), respiratory (mouth pressure device) and peripheral muscle strength (dynamometer) were evaluated. Results: Symptom QOL-subscale and depression scores were significantly higher; peripheral muscle strength, global health status, and functional QOL-subscales scores were lower in severe-fatigued recipients (p < 0.05) whose exercise capacity was clinically (28.85 m) decreased. Blood levels, pulmonary functions, dyspnea, and respiratory muscle strength were similar in groups (p > 0.05). 42.4% of the variance in severe fatigue was explained by symptom QOL-subscale score and corticosteroid use after HSCT (p < 0.001). Conclusions: Impairments in peripheral muscle strength, QOL, exercise capacity, and depression are more prevalent among severe-fatigued recipients. Moreover, poorer QOL and corticosteroid use after HSCT are most important predictors of severe fatigue. Effects of comprehensive exercise programs and psychosocial support for severe-fatigued recipients in late post-engraftment period should be investigated.