This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Meeske, K. A. Articles by Bernstein, L. Search for Related Content PubMed PubMed Citation Articles by Meeske, K. A. Articles by Bernstein, L. Social Bookmarking                            What's this?

Prevalence and Correlates of Fatigue in Long-Term Survivors of Childhood Leukemia

From the Department of Preventive Medicine and USC/Norris Comprehensive Cancer Center, and the Department of Pediatrics Keck School of Medicine; Pharmaceutical Economics and Policy, School of Pharmacy, University of Southern California; Division of Hematology-Oncology, Childrens Hospital, Los Angeles, CA

Address reprint requests to Kathleen Meeske, PhD, Childrens Center for Cancer and Blood Diseases MS #54, Childrens Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027; e-mail: kmeeske{at}chla.usc.edu

PURPOSE: To estimate the prevalence of fatigue, identify the factors associated with fatigue, and to explore the relationship between fatigue and quality of life (QOL) in long-term survivors of childhood acute lymphoblastic leukemia (ALL).

METHODS: One hundred sixty-one ALL survivors diagnosed at Childrens Hospital Los Angeles (Los Angeles, CA) before age 18 years and between January 1, 1975 and December 31, 1995, participated in a structured telephone interview. Participants were aged 18 to 41 years and off treatment for an average of 14 years. Four measures of fatigue, including the Revised–Piper Fatigue Scale, were used to assess fatigue; depression was assessed using the Center for Epidemiological Studies Depression Scale. Multivariate logistic regression models were developed to identify factors associated with fatigue and depression.

RESULTS: Prevalence of fatigue (30%) fell within the general population normal limits. Fatigue and depression were highly correlated (Pearson r = 0.75). Fatigue was associated with marriage (OR = 0.11; 95% CI, 0.02 to 0.50), having children (OR = 5.80; 95% CI, 1.30 to 25.82), sleep disturbances (OR = 6.15; 95% CI, 2.33 to 16.22), pain (OR = 5.56; 95% CI, 2.13 to 14.48), obesity (OR = 3.80; 95% CI, 1.41 to 10.26), cognitive impairment (OR = 2.56; 95% CI, 1.02 to 6.38), and exercise-induced symptoms (OR = 2.98; 95% CI, 1.11 to 8.02). Four factors associated with fatigue were also associated with depression: sleep disturbances, pain, obesity, and cognitive impairment. Fatigue was inversely related to QOL.

CONCLUSION: Some survivors of childhood ALL experience fatigue many years after treatment. Fatigued survivors represent a high-risk subgroup as they report more depression and poorer QOL than nonfatigued survivors and their peers.

Supported by Grant No. 5P30 CA 14089-25 from the National Cancer Institute, and by the Toys "" Us Children's Foundation.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				C. L. Cox, M. M. Hudson, A. Mertens, K. Oeffinger, J. Whitton, M. Montgomery, and L. L. Robison Medical Screening Participation in the Childhood Cancer Survivor Study Arch Intern Med, March 9, 2009; 169(5): 454 - 462. [Abstract] [Full Text] [PDF]

				L. S Gilchrist, M. L. Galantino, M. Wampler, V. G Marchese, G S. Morris, and K. K Ness A Framework for Assessment in Oncology Rehabilitation Physical Therapy, March 1, 2009; 89(3): 286 - 306. [Abstract] [Full Text] [PDF]

				S. F. Whitsett, M. Gudmundsdottir, B. Davies, P. McCarthy, and D. Friedman Chemotherapy-Related Fatigue in Childhood Cancer: Correlates, Consequences, and Coping Strategies Journal of Pediatric Oncology Nursing, April 1, 2008; 25(2): 86 - 96. [Abstract] [PDF]

				S. D. Sanford, J. O. Okuma, J. Pan, D. K. Srivastava, N. West, L. Farr, and P. S. Hinds Gender Differences in Sleep, Fatigue, and Daytime Activity in a Pediatric Oncology Sample Receiving Dexamethasone J. Pediatr. Psychol., April 1, 2008; 33(3): 298 - 306. [Abstract] [Full Text] [PDF]