Chronic fatigue more common after childhood leukemia, lymphoma

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Chronic fatigue is more than three times more prevalent among adult survivors of childhood or adolescent leukemia or lymphoma than among adults in the general population, a recent study has demonstrated.

The research, conducted in Norway, centered on 143 men and 147 women who had received a diagnosis of acute lymphoblastic leukemia (ALL), Hodgkin lymphoma (HL), or non-Hodgkin lymphoma (NHL) between 1970 and 2002, before they reached age 19 years. Median age at the time of the study was 29.6 years, and median time since diagnosis was 21.1 years, with all participants having survived for at least 5 years.

The prevalence of chronic fatigue was 27% among the cancer survivors (34%, 30%, and 22% among persons who had had HL, NHL, or ALL, respectively). In comparison, only 8% of 1,405 controls aged 19 to 50 years from Norway's general population suffered from chronic fatigue.

Disease characteristics and treatment or somatic late effects were not associated with the development of chronic fatigue. Leukocyte, neutrophil, and thrombocyte counts were elevated among persons with the condition. Presence of B-symptoms (fever, night sweats, weight loss) at diagnosis predicted chronic fatigue in lymphoma survivors in univariate analysis. In multivariate analysis, elevated levels of anxiety and depression predicted chronic fatigue.      

“At a median of 20 years after diagnosis, the prevalence of [chronic fatigue] in [childhood leukemia/lymphoma survivors] is more than three times that of the general population,” concluded Hanne Hamre, MD, of Oslo University Hospital, Radiumhospitalet, Oslo, Norway, and fellow researchers in Journal of Adolescent and Young Adult Oncology (2013;2[1]:2-9). “A persistent low-grade inflammatory response may be involved in the pathogenesis of [chronic fatigue].”

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