title: Persistent Fatigue in Hematopoietic Stem Cell Transplantation Survivors.
abstract: Fatigue is highly prevalent after hematopoietic stem cell transplantation (HCT). It has been described as intense and may last for years following treatment.
  
  
  
  The aim of this study is to compare fatigue, physical activity, sleep, emotional distress, cognitive function, and biological measures in HCT survivors with persistent fatigue (n = 25) with age- and gender-matched healthy controls with occasional tiredness (n = 25).
  
  
  
  Data were collected using (a) objective, real-time assessments of physical activity and sleep over 7 days; (b) patient-reported fatigue assessments; (c) computerized objective testing of cognitive functioning; and (d) biological measures. Differences between groups were examined using multivariate analysis of variance.
  
  
  
  Survivors of HCT reported increased physical (P < .001), mental (P < .001), and overall (P < .001) fatigue as well as increased anxiety (P < .05) and depression (P < .01) compared with healthy controls. Red blood cell (RBC) levels were significantly lower in HCT survivors (P < .001). Levels of RBC for both groups, however, were in the normal range. Tumor necrosis factor-α (P < .001) and interleukin-6 (P < .05) levels were significantly higher in HCT survivors.
  
  
  
  Persistent fatigue in HCT survivors compared with healthy controls with occasional tiredness is accompanied by increased anxiety and depression along with decreased RBC counts. Elevated tumor necrosis factor-α and interleukin-6 levels may be important biomarkers.
  
  
  
  This study provides preliminary support for the conceptualization of fatigue as existing on a continuum, with tiredness anchoring one end and exhaustion the other. Persistent fatigue experienced by HCT survivors is more severe than the occasional tiredness of everyday life.
authors.affiliation: Author Affiliations: Department of Biobehavioral Health Science, College of Nursing (Drs Hacker and Fink, Ms Peters); Department of Health Science Systems, College of Nursing (Dr Park); Department of Kinesiology and Nutrition, College of Applied Health Sciences (Dr Fantuzzi); Department of Hematology/Oncology, College of Medicine (Dr Rondelli), University of Illinois at Chicago.
authors.forename: Eileen Danaher
authors.initials: ED
authors.lastname: Hacker
authors.forename: Anne M
authors.initials: AM
authors.lastname: Fink
authors.forename: Tara
authors.initials: T
authors.lastname: Peters
authors.forename: Chang
authors.initials: C
authors.lastname: Park
authors.forename: Giamila
authors.initials: G
authors.lastname: Fantuzzi
authors.forename: Damiano
authors.initials: D
authors.lastname: Rondelli
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005221:Fatigue / Q000453:epidemiology*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data