Background: Cancer-related fatigue (CRF) is distressing for patients and can manifest across the cancer journey, from diagnosis, through treatment and into survivorship. CRF impacts daily activities, mood, social relationships, and work, and is associated with decreased quality of life. However, no systematic review has been conducted to analyse the prevalence of CRF specifically in patients with haematological malignancies. Understanding the prevalence of CRF amongst patients with haematological cancer may help guide assessment and management of this distressing symptom.
Aim: To determine the prevalence of CRF in patients with haematological malignancy.
Methods: The review protocol was registered with PROSPERO (2021 CRD42021258752). Medline, Embase, PyscINFO and CINAHL databases were searched from inception to July 2021. Studies published in English that utilised quantitative measures of fatigue and reporting prevalence data on fatigue in adult patients with any subtype and any stage of haematological malignancy were eligible, including new diagnosis, refractory and relapsed disease.
Results: 11625 articles were screened with 83 meeting the inclusion criteria, involving 31932 patients and sample sizes ranging from 18 to 5306 participants. The prevalence of CRF in individual studies varied from 15% to 95%. Random-effects meta-analysis determined the pooled prevalence of fatigue to be 59% (95% CI: 51-67%, 50 studies, n=14775), however heterogeneity was high (I2= 99%). Subgroup analysis showed pooled CRF prevalence of 71% in patients with Leukaemia (95% CI: 58-81%, n= 2754, I2 = 97%), 33% in those with Lymphoma (95% CI: 28-39%, n=4546, I2=92%), 59% in those with Myeloma (95%CI: 31-82%, n=728, I2 = 97) and 85% in patients with a Myeloproliferative Neoplasm (95% CI: 70-93%, n=3913, I2 =98%).
Conclusion: This systematic review highlights that fatigue is common amongst patients with haematological malignancy. Due to the known association of high CRF and low QOL, management of CRF should be prioritised across the survivorship continuum.