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 seven weekly sessions for eight 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
Twenty-seven 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 eight 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.
Key Words
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Article info
Publication history
Published online: November 12, 2022
Accepted:
November 8,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
