Long-Term Follow-Up

Depression and fatigue: Is it in the genes?

Fatigue and depression are two of the most common problems cited by patients following transplantation.

About 30 percent to 40 percent of patients are bothered by long-term fatigue, and 10 percent to 20 percent report clinical depression. Researchers are still trying to figure out why, but the likely culprit could be genetic.

"We know many patients develop fatigue and depression following a transplant. Some overcome these issues quickly, but many others don't," Hutchinson Center Dr. Stephanie Lee said.

"We are seeking to determine if there are genetic predictors that can help us identify patients who are more likely to become depressed or develop ongoing fatigue. If we can do that, we'll be able to help our patient population much better," she said.

Depression and fatigue are the focus of the current questionnaire module being sent to LTFU patients. Lee and Dr. Heather Jim, an assistant professor at Moffit Cancer Center's Department of Health Outcomes and Behavior, are collaborating on the study.

"Heather is very interested in pathways and the interplay of genetics in our overall health. And here at the Center, we have an amazing database of information based on our patients. We believe our collaboration in this study is making the most of our data to help patients in the future," Lee said.

Genes play a major role in shaping who we are. But they also play a role in our susceptibility to disease—and may be responsible for triggering or making us susceptible to depression or fatigue.

"There are many other studies in other populations that suggest that genes can help us predict if someone is more likely to become depressed or fatigued," Jim said. "It may be possible that these genes also exist in our population of BMT patients. So, we're looking for these genetic predictors."

Both researchers want to encourage all patients to fill out the short questionnaire included with the annual LTFU Patient Recovery Questionnaire. It should only take an additional five to 10 minutes to complete.

They emphasize that it's just as important for patients who have not experienced depression or fatigue to participate in the study in order to make a comparison.

As part of the study, the researchers are also asking for permission to look at patient blood samples that are stored at the Center. Researchers will be looking for genetic predictors in these samples.

"This is a very novel study," Lee said. "This is the first time we're looking at biological predictors in our BMT population."

The research is seeking to identify the rate of depression and fatigue; determine whether the type of transplant makes a difference in these rates; and whether stress management, such as exercise, is helpful to alleviate symptoms of fatigue and depression. They are also trying to determine if there are specific biological determinants that make fatigue and depression happen at the same time in some people.

"The field of genetics is moving very fast," Jim said. "Things we couldn't do in the past, we can do now."

For Lee, that means having additional tools to help our current and future patient population.

"Our ultimate goal is better care for the patient, better therapies. This is what drives our studies," Lee said.

Fred Hutchinson Cancer Research Center is a world leader in research to prevent, detect and treat cancer and other life-threatening diseases.