title: Prevalence, severity and correlates of fatigue in newly diagnosed patients with myelodysplastic syndromes.
abstract: The primary objective of this study was to investigate factors associated with fatigue severity in newly diagnosed patients with higher-risk myelodysplastic syndromes (MDS). The secondary objectives were to assess symptom prevalence and to examine the relationships between fatigue, quality of life (QoL) and overall symptom burden in these patients. The analyses were conducted in 280 higher-risk MDS patients. Pre-treatment patient-reported fatigue was evaluated with the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue scale and QoL was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). Female gender (P = 0·018), poor performance status (i.e., ECOG of 2-4) (P < 0·001) and lower levels of haemoglobin (Hb) (P = 0·026) were independently associated with higher fatigue severity. The three most prevalent symptoms were as follows: fatigue (92%), dyspnoea (63%) and pain (55%). Patients with higher levels of fatigue also had greater overall symptom burdens. The mean global QoL scores of patients with the highest versus those with the lowest levels of fatigue were 29·2 [standard deviation (SD), 18·3] and 69·0 (SD, 18·8), respectively and this difference was four times the magnitude of a clinically meaningful difference. Patient-reported fatigue severity revealed the effects of disease burden on overall QoL more accurately than did degree of anaemia. Special attention should be given to the female patients in the management of fatigue.
authors.affiliation: Data Centre and Health Outcomes Research Unit, Italian Group for Adult Haematological Diseases (GIMEMA), Rome, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Efficace
authors.forename: Gianluca
authors.initials: G
authors.lastname: Gaidano
authors.forename: Massimo
authors.initials: M
authors.lastname: Breccia
authors.forename: Marianna
authors.initials: M
authors.lastname: Criscuolo
authors.forename: Francesco
authors.initials: F
authors.lastname: Cottone
authors.forename: Giovanni
authors.initials: G
authors.lastname: Caocci
authors.forename: David
authors.initials: D
authors.lastname: Bowen
authors.forename: Michael
authors.initials: M
authors.lastname: Lübbert
authors.forename: Emanuele
authors.initials: E
authors.lastname: Angelucci
authors.forename: Reinhard
authors.initials: R
authors.lastname: Stauder
authors.forename: Dominik
authors.initials: D
authors.lastname: Selleslag
authors.forename: Uwe
authors.initials: U
authors.lastname: Platzbecker
authors.forename: Grazia
authors.initials: G
authors.lastname: Sanpaolo
authors.forename: Anna
authors.initials: A
authors.lastname: Jonasova
authors.forename: Francesco
authors.initials: F
authors.lastname: Buccisano
authors.forename: Giorgina
authors.initials: G
authors.lastname: Specchia
authors.forename: Giuseppe A
authors.initials: GA
authors.lastname: Palumbo
authors.forename: Pasquale
authors.initials: P
authors.lastname: Niscola
authors.forename: Chonghua
authors.initials: C
authors.lastname: Wan
authors.forename: Huiyong
authors.initials: H
authors.lastname: Zhang
authors.forename: Susanna
authors.initials: S
authors.lastname: Fenu
authors.forename: Virginia
authors.initials: V
authors.lastname: Klimek
authors.forename: Odile
authors.initials: O
authors.lastname: Beyne-Rauzy
authors.forename: Khanh
authors.initials: K
authors.lastname: Nguyen
authors.forename: Franco
authors.initials: F
authors.lastname: Mandelli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004417:Dyspnea / Q000453:epidemiology / Q000209:etiology; D005060:Europe / Q000453:epidemiology; D005221:Fatigue / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D011594:Psychometrics; D011788:Quality of Life; D012720:Severity of Illness Index
chemical_list: D006454:Hemoglobins
keywords: anaemia; fatigue; haemoglobin; myelodysplastic syndromes; quality of life