In a nutshell
This study aimed to investigate the impact of maintenance treatment on cancer-related fatigue and sleep-wake rhythms in pediatric patients with acute lymphoblastic leukemia.
This study concluded that sleep-wake rhythms are disturbed, physical activity levels lower and cancer-related fatigue levels higher during maintenance treatment in these patients.
Maintenance treatment is given after initial treatment to prevent or delay cancer's return. Maintenance treatment commonly includes corticosteroids. Dexamethasone (Decadron) is a corticosteroid drug commonly used in allergies and asthma. In cancer, it can be used to reduce inflammation and suppress the body's immune response. Cancer-related fatigue is one of the most common side effects of cancer treatment.
Sleep-wake rhythm (SWR) or the circadian rhythm is like a 24-hour internal clock that determines cycles of sleepiness and alertness at regular intervals. Dexamethasone is a medication that can disrupt the SWR. It was unknown what impact maintenance and dexamethasone treatment had on SWR and cancer-related fatigue in pediatric patients with acute lymphoblastic leukemia (ALL).
Methods & findings
This study involved 125 children with ALL. 113 patients received dexamethasone treatment. 81 patients did not receive dexamethasone treatment. SWR and cancer-related fatigue were compared between patients involved.
The SWR was less stable and less strong, with lower physical activity levels and higher cancer-related fatigue levels in patients with ALL when compared to healthy children. Physical activity was lower and cancer-related fatigue more severe in patients treated with dexamethasone compared to patients who did not receive dexamethasone.
Sleep-wake outcomes were associated with cancer-related fatigue in patients without dexamethasone. However, sleep-wake outcomes were not associated with cancer-related fatigue in patients who received dexamethasone.
The bottom line
This study concluded that sleep-wake rhythms are disturbed, physical activity levels lower and cancer-related fatigue levels higher during dexamethasone maintenance treatment in pediatric patients with ALL.
The fine print
Some patients did not participate in all study assessments. This might have affected the results. Further studies are needed.
Published By :
Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer
Apr 13, 2020