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Cheminet G, Corbasson A, Charmettan M, Namaoui W, Khimoud D, Flamarion E, Michon A, Lafont E, Pouchot J, Ranque B, Arlet JB. Assessment of fatigue in adult patients with sickle cell disease: Use of the functional assessment of chronic illness therapy-Fatigue (FACIT-fatigue) questionnaire. Br J Haematol 2024; 205:335-342. [PMID: 38802081 DOI: 10.1111/bjh.19568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/15/2024] [Indexed: 05/29/2024]
Abstract
Few studies have used validated scales to assess the intensity and determinants of fatigue, a major symptom of sickle cell disease (SCD). We aimed to assess the level of basal fatigue in adult patients with SCD, using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) questionnaire. We prospectively included 102 stable adult outpatients with SCD over 2 months, who answered the FACIT-Fatigue (ranging from 0 (worst imaginable fatigue) to 52 (no fatigue)) and reported on the intensity of fatigue and its impact on quality of life. The cut-off for significant fatigue was <34. The median [IQR] FACIT-Fatigue score was 29 [22-37], indicating moderate-to-severe fatigue. In a multivariate analysis, the FACIT-Fatigue score was significantly associated with female sex, high body mass index, high level of stress, poor sleep quality, and number of previous episodes of acute chest syndrome, but not with the genotype or the haemoglobin level. Most adult patients with SCD experience significant and sometimes intense fatigue; this is probably due to several factors, including disease activity. Fatigue should be evaluated systematically during consultations and in patient education programmes and as an end-point in therapeutic trials.
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Affiliation(s)
- Geoffrey Cheminet
- Service de médecine Interne, Centre National de Référence des syndromes drépanocytaires majeurs de l'adulte, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Cité, Inserm U1163, Institut Imagine, Laboratoire "Mécanismes cellulaires et moléculaires des désordres hématologiques et implications thérapeutiques", Paris, France
- Laboratoire d'Excellence GR-Ex, Paris, France
| | - Anne Corbasson
- Service de médecine Interne, Centre National de Référence des syndromes drépanocytaires majeurs de l'adulte, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
| | - Marie Charmettan
- Service de médecine Interne, Centre National de Référence des syndromes drépanocytaires majeurs de l'adulte, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
| | - Walid Namaoui
- Service de médecine Interne, Centre National de Référence des syndromes drépanocytaires majeurs de l'adulte, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
| | - Djamal Khimoud
- Service de médecine Interne, Centre National de Référence des syndromes drépanocytaires majeurs de l'adulte, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
| | - Edouard Flamarion
- Service de médecine Interne, Centre National de Référence des syndromes drépanocytaires majeurs de l'adulte, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
| | - Adrien Michon
- Service de médecine Interne, Centre National de Référence des syndromes drépanocytaires majeurs de l'adulte, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
| | - Emmanuel Lafont
- Service de médecine Interne, Centre National de Référence des syndromes drépanocytaires majeurs de l'adulte, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
| | - Jacques Pouchot
- Service de médecine Interne, Centre National de Référence des syndromes drépanocytaires majeurs de l'adulte, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Cité, Faculté de Santé, Paris, France
| | - Brigitte Ranque
- Service de médecine Interne, Centre National de Référence des syndromes drépanocytaires majeurs de l'adulte, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
- Laboratoire d'Excellence GR-Ex, Paris, France
- Université Paris Cité, Faculté de Santé, Paris, France
- Université Paris Cité, Inserm U970, PARCC (Paris Centre de Recherche Cardiovasculaire), Paris, France
| | - Jean-Benoît Arlet
- Service de médecine Interne, Centre National de Référence des syndromes drépanocytaires majeurs de l'adulte, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
- Université Paris Cité, Inserm U1163, Institut Imagine, Laboratoire "Mécanismes cellulaires et moléculaires des désordres hématologiques et implications thérapeutiques", Paris, France
- Laboratoire d'Excellence GR-Ex, Paris, France
- Université Paris Cité, Faculté de Santé, Paris, France
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Bizri M, Koleilat R, Akiki N, Dergham R, Mihailescu AM, Bou-Fakhredin R, Musallam KM, Taher AT. Quality of life, mood disorders, and cognitive impairment in adults with β-thalassemia. Blood Rev 2024; 65:101181. [PMID: 38341336 DOI: 10.1016/j.blre.2024.101181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 02/12/2024]
Abstract
Advances in understanding the disease process in β-thalassemia supported development of various treatment strategies that resulted in improved survival. Improved survival, however, allowed multiple morbidities to manifest and cemented the need for frequent, lifelong treatment. This has directly impacted patients' health-related quality of life and opened the door for various psychiatric and cognitive disorders to potentially develop. In this review, we summarize available evidence on quality of life, depression and anxiety, suicidality, and cognitive impairment in adult patients with β-thalassemia while sharing our personal insights from experience in treating patients with both transfusion-dependent and non-transfusion-dependent forms.
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Affiliation(s)
- Maya Bizri
- Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rawan Koleilat
- Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nathalie Akiki
- Department of Haematology, King's College Hospital, London, United Kingdom
| | - Reem Dergham
- Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon
| | | | - Rayan Bou-Fakhredin
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Khaled M Musallam
- Center for Research on Rare Blood Disorders (CR-RBD), Burjeel Medical City, Abu Dhabi, United Arab Emirates
| | - Ali T Taher
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
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