First, exercise was contraindicated in patients with anaemia, thrombocytopenia, active infection, bone lesion and risk of falls. Management of CRF in patients with haematological cancer remained challenging despite studies reporting non-pharmacological measures, particularly exercise and psychological interventions might significantly improve CRF. ![]() CRF had significant negative impact on patients’ quality of life, daily activities, employment, social relationships and mood 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. Fatigue was not only the most prevalent symptom of haematological cancer, it was also the commonest side-effect of haematological cancer treatments such as cytotoxic chemotherapy or marrow suppressive agents. 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. Almost 70% of haematological cancer patients reported fatigue. Among the symptoms, fatigue was the most prevalent. Patients with haematological cancers have considerable symptom burden, with an average of 8.8 symptoms per patient according to one cross-sectional study. They accounted for 10% of all malignancies and 9.5% of malignancies-related mortality. Haematological cancers include leukaemia, lymphoma, multiple myeloma, myeloproliferative neoplasms and myelodysplastic syndrome. NCT 05029024, date of registration 15th August 2021. On top of all the currently available methods, 30-min mindful breathing can prove a valuable addition. Our results provide evidence that a single session of 30-min mindful breathing was effective in reducing fatigue in haematological cancer patients. The calculated effect size Cohen’s d was 1.4 for between-group comparison of differences in total FACIT-fatigue score. 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. 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. There was no difference in the demographic and clinical characteristics between the 2 groups.Īt 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). 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%). Of 197 patients screened, 80 were eligible and they were equally randomised into 30-min mindful breathing versus 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. 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. ![]() 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). We 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 with haematological cancer had considerable symptom burden, in which fatigue was the most prevalent.
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