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Fatigue in Long-Term Hodgkin's Disease Survivors: A Follow-Up Study

From the Ullevål University Hospital HF; Department of Behavioral Sciences in Medicine, University of Oslo; Departments of Medical Oncology and Clinical Research, the Norwegian Radium Hospital, Oslo; and Department of Clinical and Molecular Medicine, Faculty of Medicine, the Norwegian University of Technology and Science, Trondheim, Norway

Address reprint requests to Marianne Jensen Hjermstad, Department of Oncology, Ullevål University Hospital HF, KSLB, 0407 Oslo, Norway; e-mail: m.j.hjermstad{at}basalmed.uio.no

PURPOSE: 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.

PATIENTS AND 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.

CONCLUSION: 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.

Supported by the National Cancer Society.

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

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