Abstract
Background: Assessing and managing symptom is a core role of oncology nurses. Fatigue is the most common and distressing symptoms in cancer patients. Mechanism-specific interventions are not currently available and most interventions are supportive care, such as exercise. Its pathophysiological mechanisms are still unclear, complex and multifactorial. A plausible hypothetical mechanisms is the pro-inflammatory cytokines dysregulation hypothesis. Yet, the evidence for which cytokines and what time point would play a role in fatigue experience is uncertain at this time point due to design issues of the studies.
Objectives: We examined (a) the patterns of changes in fatigue severity during chemotherapy for hematologic cancer, and (b) whether fatigue change is associated with cytokines (IL-1 alpha, IL-1 beta, IL-6) in controlling for hemoglobin/hematocrit.
Methods: This study was a longitudinal cohort study. We recruited 148 hematological cancer patients awaiting chemotherapy. We collected data at four time points: the prior to chemotherapy (T1, on the day or prior to CTX day), at the last day of chemotherapy (T2), at one week after the chemotherapy completion (T3), and one month after T1 (T4). We performed latent growth curve modeling to examine the patterns of changes in fatigue severity and its associations with cytokines and hemoglobin/hematocrit.
Results: Latent growth curve modeling identified a quadratic growth curve model, showing the good model fit (comparative fit index = 0.99, Tucker- Lewis index =0.98, RMSEA =0.05 ), and high variance explanation power (R2 = 0.61 -0.69, fatigue severity across time point). That is, fatigue severity changed in a quadratic growth curve pattern. Fatigue severity increased from T1 to T2 (the end of chemotherapy) and then decreased over time (T3 &T4). IL-6 significantly influenced fatigue severity at T1, T2, T3, but not at T4 (i.e., 1 month after the baseline assessment). The impact of IL-6 on fatigue was independent from the impact of hemoglobin level/hematocrit, though most patients were anemic.
Conclusions: We provide evidence of longitudinal associations between fatigue severity and cytokines. The influence of IL-6 on fatigue is greater than the impact of hemoglobin level. Yet, the influence of IL-6 may be limited during and shortly after chemotherapy. This indicates the impact time point of cytokines on symptom experience. The findings can guide the development of new symptom management strategies.
Notes
References:
Berger AM, Mooney K, Alvarez-Perez A, et al. (2015) Cancer-related fatigue, Version 2.2015. J Nat Comp Canc Net 13(8):1012–1039. https://doi.org/10.6004/jnccn.2015.0122
Oswald LB, Venditti A, Cella D, et al. (2023) Fatigue in newly diagnosed acute myeloid leukaemia: General population comparison and predictive factors. BMJ Sup Pal Care. Advance online publication. https://doi.org/10.1136/bmjspcare-2020-002312
Wang XS, Shi Q, Shah ND, et al. (2014) Inflammatory markers and development of symptom burden in patients with multiple myeloma during autologous stem cell transplantation. Clin Canc Res 20(5):1366–1374. https://doi.org/10.1158/1078-0432.CCR-13-2442
Huang HP, Chen ML, Liang J, Miaskowski C. (2014) Changes in and predictors of severity of fatigue in women with breast cancer: A longitudinal study. Int J Nurs Stud 51(4):582–592. https://doi.org/10.1016/j.ijnurstu.2013.09.003
Miaskowski C, Dodd M, Lee K, et al. (2010) Preliminary evidence of an association between a functional interleukin-6 polymorphism and fatigue and sleep disturbance in oncology patients and their family caregivers. J Pain Symp Manage 40(4):531–544. https://doi.org/10.1016/j.jpainsymman.2009.12.006
Sigma Membership
Lambda Alpha at-Large
Type
Poster
Format Type
Text-based Document
Study Design/Type
Cohort
Research Approach
Quantitative Research
Keywords:
Implementation Science, Cancer Patients, Fatigue, Oncology Nursing, Cytokines
Recommended Citation
Kim, Heeju; Moon, Joon Ho; and Raykov, Tenko, "Longitudinal Association of Fatigue with Cytokines Over the Course of Hematologic Cancer Treatment" (2025). International Nursing Research Congress (INRC). 111.
https://www.sigmarepository.org/inrc/2025/posters_2025/111
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Longitudinal Association of Fatigue with Cytokines Over the Course of Hematologic Cancer Treatment
Seattle, Washington, USA
Background: Assessing and managing symptom is a core role of oncology nurses. Fatigue is the most common and distressing symptoms in cancer patients. Mechanism-specific interventions are not currently available and most interventions are supportive care, such as exercise. Its pathophysiological mechanisms are still unclear, complex and multifactorial. A plausible hypothetical mechanisms is the pro-inflammatory cytokines dysregulation hypothesis. Yet, the evidence for which cytokines and what time point would play a role in fatigue experience is uncertain at this time point due to design issues of the studies.
Objectives: We examined (a) the patterns of changes in fatigue severity during chemotherapy for hematologic cancer, and (b) whether fatigue change is associated with cytokines (IL-1 alpha, IL-1 beta, IL-6) in controlling for hemoglobin/hematocrit.
Methods: This study was a longitudinal cohort study. We recruited 148 hematological cancer patients awaiting chemotherapy. We collected data at four time points: the prior to chemotherapy (T1, on the day or prior to CTX day), at the last day of chemotherapy (T2), at one week after the chemotherapy completion (T3), and one month after T1 (T4). We performed latent growth curve modeling to examine the patterns of changes in fatigue severity and its associations with cytokines and hemoglobin/hematocrit.
Results: Latent growth curve modeling identified a quadratic growth curve model, showing the good model fit (comparative fit index = 0.99, Tucker- Lewis index =0.98, RMSEA =0.05 ), and high variance explanation power (R2 = 0.61 -0.69, fatigue severity across time point). That is, fatigue severity changed in a quadratic growth curve pattern. Fatigue severity increased from T1 to T2 (the end of chemotherapy) and then decreased over time (T3 &T4). IL-6 significantly influenced fatigue severity at T1, T2, T3, but not at T4 (i.e., 1 month after the baseline assessment). The impact of IL-6 on fatigue was independent from the impact of hemoglobin level/hematocrit, though most patients were anemic.
Conclusions: We provide evidence of longitudinal associations between fatigue severity and cytokines. The influence of IL-6 on fatigue is greater than the impact of hemoglobin level. Yet, the influence of IL-6 may be limited during and shortly after chemotherapy. This indicates the impact time point of cytokines on symptom experience. The findings can guide the development of new symptom management strategies.
Description
This study: