Abstract
Historically, sickness symptomatology in cancer patients has been studied as aggregated phenomena arising from a similar inflammatory etiology. A parent clinical trial analyzed depression, anxiety, fatigue, sleep, and pain as separate variables in hematopoietic cell transplant (HCT) recipients experiencing cytokine blockade with an interleukin-6 receptor antagonist, tocilizumab. Contrary to initial hypotheses, tocilizumab recipients had worse post-HCT levels of depression, anxiety, pain, and sleep. Interestingly, we found that fatigue, as assessed by the Fatigue Symptom Inventory (FSI) administered at baseline and post-transplant days + 28 (D + 28), D + 100, and D + 180, was not similarly affected. Fatigue levels did not differ between the 25 patients who received one prophylactic dose of tocilizumab prior to allogeneic HCT and a historical control group of 63 HCT patients who did not receive tocilizumab. In addition, whereas fatigue scores pre- and post-HCT were correlated in control patients (0.54 at D + 28, p
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