Abstract
Background: Fatigue is a common and disabling side effect of targeted therapies such as tyrosine kinase inhibitors (TKIs) used to treat chronic myeloid leukemia (CML). The goal of the current study was to conduct a pilot randomized trial of the first cognitive behavioral intervention developed for fatigue due to targeted therapy. Methods: Patients with CML treated with a TKI who were reporting moderate to severe fatigue were recruited and randomized 2:1 to cognitive behavioral therapy for targeted therapy–related fatigue (CBT-TTF) delivered via FaceTime for the iPad or to a waitlist control (WLC) group. The outcomes were acceptability, feasibility, and preliminary efficacy for fatigue (Functional Assessment of Chronic Illness Therapy–Fatigue; primary outcome) and quality of life (Functional Assessment of Cancer Therapy–General; secondary outcome). Participants were assessed before randomization and after treatment (ie, approximately 18 weeks later). Results: A total of 44 patients (mean age, 55 years; 48% female) were assigned to CBT-TTF (n = 29) or WLC (n = 15). The study participation rate was 59%. Among the patients assigned to CBT-TTF, 79% completed the intervention. Intent-to-treat analyses indicated that patients assigned to CBT-TTF demonstrated greater improvements in fatigue (d = 1.06; P <.001) and overall quality of life (d = 1.15; P =.005) than those assigned to WLC. More patients randomized to CBT-TTF than WLC demonstrated clinically significant improvements in fatigue (85% vs 29%) and quality of life (88% vs 54%; P values ≤.016). Conclusions: CBT-TTF displays preliminary efficacy in improving fatigue and quality of life among fatigued patients with CML treated with TKIs. The findings suggest that a larger randomized study is warranted.
Original language | English |
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Pages (from-to) | 174-180 |
Number of pages | 7 |
Journal | Cancer |
Volume | 126 |
Issue number | 1 |
DOIs | |
Publication status | Published - 1 Jan 2020 |
Keywords
- chronic myeloid leukemia
- cognitive behavioral therapy
- fatigue
- quality of life
- randomized controlled trial