title: Persisting fatigue in Hodgkin lymphoma survivors: a systematic review.
abstract: Hodgkin Lymphoma (HL) survivors are at risk for adverse psychosocial events as a result from cancer diagnosis and treatment. Fatigue is one of the most frequently reported long-term symptoms and is often reported to interfere with daily life. We conducted a systematic review to determine prevalence, severity and predisposing factors of fatigue in HL survivors. A literature search was conducted up to August 2012. Twenty-two articles comparing HL survivors with norm population data met all predefined selection criteria. Prevalence rates, levels of fatigue and clinical relevance of the results were determined. Prevalence of fatigue ranged from 11-76 % in HL survivors compared to 10 % in the general population. Mean fatigue scores were 5-13 % higher compared to the normative population; these findings were clinically relevant in 7 out of 11 studies. Increasing age was associated with higher levels of fatigue in HL survivors. Treatment modality and stage of initial disease were not associated with higher fatigue levels, while comorbidities or other treatment sequelae seemed to impact on the levels of fatigue. HL survivors are at serious risk for developing clinically relevant, long-term fatigue. The impact of patient and treatment characteristics on risk of fatigue is limited. Focus for future research should shift to the role of late-treatment sequelae and psychological distress symptoms.
authors.affiliation: Departments of Clinical Oncology, K1-P, Leiden University Medical Center, Albinusdreef 2, Leiden, The Netherlands. l.a.daniels@lumc.nl
authors.forename: Laurien A
authors.initials: LA
authors.lastname: Daniëls
authors.forename: Simone
authors.initials: S
authors.lastname: Oerlemans
authors.forename: Augustinus D G
authors.initials: AD
authors.lastname: Krol
authors.forename: Lonneke V
authors.initials: LV
authors.lastname: van de Poll-Franse
authors.forename: Carien L
authors.initials: CL
authors.lastname: Creutzberg
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000150:complications* / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D017741:Survivors; D055815:Young Adult