Abstract
Background
Despite cancer related fatigue (CRF) being the most common, and debilitating symptom
in patients with recently diagnosed acute hematological malignancies (HM), there are
limited effective treatments for CRF in HM. The aim of this study was to determine
the feasibility of cognitive behavioral therapy (CBT) for CRF in HM.
Methods
In this preliminary longitudinal prospective study, HM patients diagnosed a median
of one month previously with moderate to severe fatigue were enrolled. Patients received
CBT in 7 weekly sessions for 8 weeks. Change in Functional Assessment of Cancer Illness
Therapy (FACIT) - Fatigue (primary), FACT-G, Pittsburg Sleep Quality Index (PSQI),
Hospital Anxiety Depression Scale (HADS), M.D. Anderson Symptom Inventory - Acute
Myeloid Leukemia (MDASI-AML/MDS), and Herth Hope Index (HHI) were analyzed.
Results
27 of 36 (75 %) patients were evaluable. Adherence and satisfaction rates to the CBT
intervention were 78.6% (95% CI 67.2%, 89.9%), and 92% (95% CI 76.7%, 98.3%) respectively.
The median age 66, 64% female, the most common HM was AML (60%), median FACIT-F was
27. The mean (SD) improvement at end 8 weeks for FACIT-F was 5.5(13.6), Cohen δ 0.4,
P=0.046; and for PSQI total was 2.9 (3), Cohen δ -1, P=0.006. We also found significant
improvement in HADS anxiety -2.7(4.5), P=0.049, MDASI Sleep -1.8(3.0), P=0.022, MDASI
mean module symptom severity -0.7(1.6), P=0.006. However, no significant improvements
were found in FACT-G, HHI, and HADS-depression scores.
Conclusions
The use of CBT was feasible with improvement of CRF, sleep quality, and anxiety scores
in HM. Randomized controlled trials are justified.
Keywords
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Article Info
Publication History
Accepted:
November 8,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Published by Elsevier Inc. on behalf of American Academy of Hospice and Palliative Medicine.
