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Fatigue in Patients With CML: Focus on Physical Activity

By: Joseph Cupolo
Posted: Friday, September 4, 2020

Fatigue is a common side effect of tyrosine kinase inhibitor (TKI) therapy in patients with chronic myeloid leukemia (CML). However, the prevalence of TKI-induced fatigue remains uncertain, and little is known about predictors of fatigue and its relationship with physical activity. Thus, Lando Janssen, MD, of Radboud University Medical Center, Nijmegen, The Netherlands, and colleagues set out to objectively assess physical levels and compare them between fatigued and nonfatigued patients.

Their study, published in Haematologica, focused on 357 participants: 247 patients with CML and 110 controls. The participants completed an online questionnaire to enable the assessment of fatigue severity and fatigue predictors. In addition, physical activity levels were objectively assessed via an activity monitor for 7 consecutive days in 138 severely fatigued and nonfatigued patients with CML.

The prevalence of severe fatigue was 55.5% in patients with CML and 10.9% in controls. Five predictors of fatigue were identified: age, female gender, Charlson Comorbidity Index, use of co-medication known to cause fatigue, and levels of physical inactivity. Objective monitoring of activity patterns confirmed that fatigued patients performed less physical activity of both light and moderate-to-vigorous intensity.

A takeaway from this study was that severe fatigue was neither independently associated with treatment-related factors such as TKI therapy dose and duration nor with disease control. Another interesting finding was that hemoglobin levels did not differ between fatigued and nonfatigued patients. These findings suggest the importance of recognizing a reduction in fatigue as a treatment goal in CML and the need for future studies to identify physical activity as a possible target to achieve this goal.

The investigators concluded: “These findings suggest there is a subset of CML patients who are particularly prone to TKI-induced fatigue and severely fatigued patients have reduced physical activity levels.”

Disclosure: The study authors reported no conflicts of interest.

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