Fatigue in long-term Hodgkin's Disease survivors: a follow-up study.
OBJECTIVE
To describe total fatigue (TF) and chronic fatigue (CF) in 476 long-term Hodgkin's disease survivors (HDSs). The development in CF over time was explored in 280 of the patients who had also been assessed 8 years earlier.


METHODS
In 2003, the Fatigue Questionnaire was mailed to 610 successfully treated HDSs at the Norwegian Radium Hospital from 1971 to 1997. Mean TF scores and occurrence of CF were compared with general population (GP) values.


RESULTS
Four hundred seventy-six complete forms (81%) were received (median age, 46 years; 56% males, median follow-up time, 195 months). There was a positive association between age and TF (P < .05), whereas presence of B symptoms at diagnosis and treatment before 1980 were associated with CF. Mean TF scores were elevated in HDSs compared with the GP (mean TF score, 14.6; 95% CI, 14.1 to 15.7 v 12.1; 95% CI, 11.9 to 12.3, respectively; P < .001), as was the proportion of persons with CF (30% v 11%, respectively; odds ratio = 3.6; P < .001). The 70 patients with CF 8 years earlier still reported higher TF at follow-up than the 210 patients without CF at the previous assessment (mean TF score, 17.0; 95% CI, 15.6 to 18.3 v 13.1; 95% CI, 12.9 to 14.1, respectively; P < .001). Significantly more patients with persisting CF had B symptoms at diagnosis compared with patients who had recovered (P = .05). No significant association with treatment modality and intensity was found.


CONCLUSIONS
Fatigue remains a major complaint in HDSs several years after treatment, but the association between treatment and fatigue still remains unclear. Many HDSs may recover from CF, particularly patients without B symptoms at diagnosis.
Hjermstad
Marianne J
MJ
Department of Oncology, Ullevål University Hospital HF, KSLB, 0407 Oslo, Norway. m.j.hjermstad@basalmed.uio.no
Fosså
Sophie D
SD
Oldervoll
Line
L
Holte
Harald
H
Jacobsen
Anne B
AB
Loge
Jon H
JH
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000704:Analysis of Variance; D003131:Combined Modality Therapy; D005221:Fatigue / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D015673:Fatigue Syndrome, Chronic / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006689:Hodgkin Disease / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D015995:Prevalence; D011336:Probability; D011788:Quality of Life; D012720:Severity of Illness Index; D017678:Sex Distribution; D018434:Sickness Impact Profile; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D017741:Survivors; D013997:Time Factors