Abstract
BackgroundPatients with haematological cancer had considerable symptom burden, in which fatigue was the most prevalent. Almost 70% of haematological cancer patients reported fatigue.MethodsWe conducted a parallel-group, non-blinded, randomised control trial at the haemato-oncology unit of University Malaya Medical Centre, from 1st October 2019 to 31st May 2020. Patients included were ≥ 18 years, had histopathological diagnosis of haematological cancer, and fatigue score of ≥4 based on the fatigue subscale of Edmonton Symptom Assessment System (ESAS). Patients allocated to the intervention group received standard care plus a guided 30-min mindful breathing session, while those in control group received standard care. The study outcomes include fatigue severity according to the fatigue subscale of ESAS, visual analogue scale of 0 – 10, and Functional Assessment of Chronic Illness Therapy Fatigue Scale Version 4, at minute 0 and minute 30.ResultsOf 197 patients screened, 80 were eligible and they were equally randomised into 30-min mindful breathing versus standard care. Lymphoma (58.9%) was the commonest haematological malignancy, followed by multiple myeloma (13.8%), acute leukaemia (11.3%), myeloproliferative neoplasm (6.3%), chronic leukaemia (5.0%) and myelodysplastic syndrome (5.0%). There was no difference in the demographic and clinical characteristics between the 2 groups.At minute 0, both arms of patients had similar ESAS-fatigue score (median, 5) and FACIT-fatigue score (mean ± SD, 24.7 ± 10.6 for intervention group versus 24.7 ± 9.7 for control group). At minute 30, intervention group had lower ESAS-fatigue score (median, 3 versus 5) and FACIT-fatigue score (mean ± SD, 17.1 ± 10.5 versus 24.8 ± 11.3) compared to control group. Both the ESAS-fatigue score reduction (median, − 2 versus 0, p = 0.002) and FACIT-fatigue score reduction (mean ± SD, − 6.7 versus + 0.8; p < 0.001) for the intervention group were statistically significant. The calculated effect size Cohen’s d was 1.4 for between-group comparison of differences in total FACIT-fatigue score.ConclusionsOur results provide evidence that a single session of 30-min mindful breathing was effective in reducing fatigue in haematological cancer patients. On top of all the currently available methods, 30-min mindful breathing can prove a valuable addition.Trial registrationNCT 05029024, date of registration 15th August 2021. (Retrospectively registered).
Highlights
Patients with haematological cancer had considerable symptom burden, in which fatigue was the most prevalent
Our results provide evidence that a single session of 30-min mindful breathing was effective in reduc‐ ing fatigue in haematological cancer patients
The National Comprehensive Cancer Network defined cancer-related fatigue (CRF) as a distressing, persistent and subjective sense of physical, emotional, or cognitive tiredness or exhaustion associated with cancer or cancer-related treatment, that is disproportional to recent activity, and interferes with usual functioning [5]
Summary
Patients with haematological cancer had considerable symptom burden, in which fatigue was the most prevalent. Haematological cancers include leukaemia, lymphoma, multiple myeloma, myeloproliferative neoplasms and myelodysplastic syndrome [1, 2]. They accounted for 10% of all malignancies and 9.5% of malignancies-related mortality [3]. Fatigue might persist for many years or remain for life in patients who had successfully achieved haematological cancer remission, post cytotoxic chemotherapy or haematopoeitic stem-cell transplantation [12,13,14,15]. CRF had significant negative impact on patients’ quality of life, daily activities, employment, social relationships and mood [16]
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