Graduation Year


Document Type




Degree Granting Department


Major Professor

Susan C. McMillan, Ph.D., A.R.N.P.

Committee Member

Cindy S. Tofthagen, Ph.D., A.R.N.P.

Committee Member

Brandy L. Lehman, Ph.D., R.N.


cancer, adults, persistent fatigue, survivors, bone marrow transplant


Fatigue is a common problem among cancer patients, especially those who have received chemotherapy and radiation therapy. Stem cell transplant (SCT) patients are at a particular risk of persistent fatigue as they receive more aggressive therapies. This study examined the prevalence of fatigue after completion of SCT. Further, the level of fatigue symptom distress and its relationship with quality of life (QOL) among long term SCT survivors was examined.

The study involved thirty-three patients, 21 males and 12 females, treated with autologous or allogeneic SCT in a comprehensive cancer center in Southwest Florida. Participants' ages ranged from 36 to 70 years, with a mean age of 53 years. All subjects completed the Cancer Related Fatigue Distress Scale and the Functional Assessment of Cancer Therapy-Bone Marrow Transplant questionnaires. All the patients had to be at least six months from transplant.

The results of this study showed that fatigue is quite prevalent among SCT survivors. Ninety-three percent of the patients reported some degree of fatigue, and 15% experienced severe fatigue. Patients who received autologous transplant (24%) reported less fatigue symptom distress (mean= 48, SD= 36.62) compared to the allogeneic transplant group (mean= 66.2, SD= 54.49). A strong negative relationship was found between fatigue symptom distress and QOL (r = 0.85, p < 0.0001) suggesting that patients with the greatest fatigue distress report the worst QOL. The time from transplant factor was significantly positively associated with fatigue symptom distress (r= 0.46, p= 0.007) indicating greater distress with the passage of time. A moderate negative relationship was also found between time from transplant and QOL (r= -0.34, p= 0.052) suggesting that QOL was less in some patients as time passed; however this was a weak relationship that did not achieve statistical significance.

Although the sample size was small, this study was able to provide a confirmation that fatigue symptom distress and QOL are related to one another. Understanding the relationship between fatigue symptom distress and QOL should encourage interdisciplinary collaboration in planning proper interventions to minimize fatigue. This would improve the outcomes of SCT long term survivors, and would positively impact their overall QOL.