Management of fatigue in children and adolescents with cancer and in paediatric recipients of haemopoietic stem-cell transplants: a clinical practice guideline

The Lancet Child & Adolescent Health
Paula D RobinsonLillian Sung

Abstract

Fatigue is a prevalent and distressing symptom in children and adolescents with cancer and in those who have undergone haemopoietic stem-cell transplantation. A multidisciplinary and multinational group of experts in paediatric oncology and fatigue, together with patient advocates, developed a clinical practice guideline for management of fatigue on the basis of systematic reviews that included six paediatric and 456 adult randomised studies. We used the Grading of Recommendations Assessment, Development and Evaluation approach to generate recommendations, and made strong recommendations, supported by evidence of moderate quality, for use of physical activity, relaxation, and mindfulness to reduce fatigue. When these approaches are unsuccessful or not feasible, cognitive or cognitive behavioural therapies may be offered (weak recommendation supported by evidence of moderate quality). Maturity and cognitive ability of individual patients will affect the feasibility of interventions. Systemic pharmacological approaches should not be routinely used to manage fatigue in children. Apart from identification of optimal approaches to implement recommended interventions in clinical practice, future research should also address knowledge...Continue Reading

Citations

Jul 30, 2019·Pediatric Research·L Lee DupuisLillian Sung
Jun 9, 2019·Archives of Disease in Childhood·Merel M Nap-van der VlistSanne L Nijhof
Nov 28, 2018·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Deborah TomlinsonLillian Sung
Feb 4, 2019·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Eliana SteinLillian Sung
Aug 28, 2019·Global Advances in Health and Medicine : Improving Healthcare Outcomes Worldwide·E Anne LownFrederick M Hecht
Aug 7, 2020·Journal of the National Comprehensive Cancer Network : JNCCN·Kimberly DaviesDeborah A Freedman-Cass
Jan 28, 2020·Seminars in Oncology Nursing·Lynn TannerJessica Sparrow
Mar 10, 2021·Journal of Pediatric Oncology Nursing : Official Journal of the Association of Pediatric Oncology Nurses·Lei ChengChangrong Yuan
Mar 6, 2021·BMJ Paediatrics Open·Merel M Nap-van der VlistSanne L Nijhof
May 28, 2021·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Paula D RobinsonLillian Sung
Jul 10, 2021·Pediatric Rheumatology Online Journal·K Kant-SmitsJ Van der Net
Jul 27, 2021·Cancer Reports·Vera CeledónMarcela Zubieta

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