LAUSR

Fatigue is a commonly reported quality of life concern after hematopoietic stem cell transplant (HSCT). Fatigue severity, duration, and interference with daily activities were evaluated at post-transplant milestones during acute recovery and through 6 years post-HSCT. We also investigated whether disease and treatment factors (allogeneic or autologous graft, diagnosis, treatment regimen), inflammation, and psychological symptoms during the peri-transplant period predicted early and long-term fatigue. Participants were 433 (191 allogeneic, 242 autologous) HSCT recipients who completed measures of fatigue (FSI), depression and anxiety (IDAS) pre-HSCT, and 1, 3, and 6 months, and 1, 3, and 6 years post-HSCT. A subset (n = 210) provided blood samples during the first 6 months post-HSCT for determination of circulating cytokine levels (IL-6, TNFα, IL-10). The majority of participants reported clinically significant fatigue at 1 (83.9%), 3 (68.4%), and 6 months (64.7%) post-HSCT. Mixed effects regression models evaluated predictors of fatigue during early recovery. Allogeneic HSCT recipients showed a slower recovery, reporting more fatigue than autologous HSCT recipients at 3 and 6 months post-HSCT, but comparable fatigue at other points (interaction z=2.99, p=0.003). No other disease or treatment factors predicted fatigue. After covarying for transplant type and patient age, higher IL-6, TNFα and IL-10 levels (all p