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Yüksek Doz Kemoterapi Alan Hastaların Yaşadıkları Semptomların Değerlendirilmesi

Year 2026, Volume: 15 Issue: 1 , 145 - 154 , 28.02.2026
https://doi.org/10.53424/balikesirsbd.1739967
https://izlik.org/JA32JC29GT

Abstract

Amaç: Bu çalışmanın amacı, yüksek doz kemoterapi alan hematolojik kanser hastalarının yaşadıkları semptomları belirlemektir. Gereç ve Yöntem: Tanımlayıcı kesitsel tasarımdaki bu çalışma, bir üniversite hastanesinin hematoloji kliniğinde tedavi gören 158 hasta ile gerçekleştirilmiştir. Veriler kişisel bilgi formu ve “Edmonton Semptom Tanılama Ölçeği” kullanılarak toplanmıştır. Bulgular: Araştırmaya dâhil edilen hastaların yaş ortalaması 45.37±13.24 ve %51.9'u kadındır. Hastaların sırasıyla en fazla yorgunluk (%76.6), iştahsızlık (%66.5), ağrı (%48.7) ve üzüntü (%48.7) semptomlarını yaşadığı belirlenmiştir. Özellikle, birçok semptomun birinci hafta puan ortalamalarının (ağrı, yorgunluk, bulantı, uykusuzluk, iştahsızlık, kendini iyi hissetme durumu, nefes darlığı, ciltte ve tırnaklarda değişiklik, stomatit veya ağız yarası), tedavi öncesine ve/veya ikinci haftaya göre anlamlı derecede daha yüksek olduğu bulunmuştur (p<0.05). Sonuç: Sonuç olarak, yüksek doz kemoterapi alan hastalarda en sık yorgunluk, iştahsızlık, ağrı ve üzüntü semptomları görülmüş ve birçok semptomun şiddeti özellikle birinci haftada artmıştır. Bu bulgular doğrultusunda, hemşirelerin tedavinin erken döneminde semptomları yakından değerlendirmesi, proaktif semptom yönetimi stratejileri uygulaması ve bireyselleştirilmiş bakım planları geliştirmesi önerilmektedir.

Ethical Statement

Kurum: Gümüşhane Üniversitesi Bilimsel Araştırma Etik Kurulu Tarih: 28.02.2023 Onay numarası: E-95674917-108.99-164417

Supporting Institution

Bu çalışma, herhangi bir kişi veya kuruluştan finansal destek almamıştır.

Thanks

Yazarlar, bu çalışmaya katkıda bulunan tüm kişilere içtenlikle teşekkür ederler.

References

  • Akin, S., & Durna, Z. (2013). A comparative descriptive study examining the perceptions of cancer patients, family caregivers, and nurses on patient symptom severity in Turkey. European Journal of Oncology Nursing, 17(1), 30-37. https://doi.org/10.1016/j.ejon.2012.02.002
  • Allart-Vorelli, P., Porro, B., Baguet, F., Michel, A., & Cousson-Gélie, F. (2015). Haematological cancer and quality of life: a systematic literature review. Blood Cancer Journal, 5(4), e305-e305. https://doi.org/10.1038/bcj.2015.29
  • Arpacı, F. (2004). Yüksek doz kemoterapi ve radyoterapi uygulaması. Türk Hematoloji Derneği Kan ve Kemik İliği Transplantasyonu Kursu.
  • Bruera, É., Kuehn, N., Miller, M. J., Selmser, P., & Macmillan, K. (1991). The Edmonton symptom assessment system (ESAS): A simple method for the assessment of palliative care patients. Journal of Palliative Care, 7(2), 6-9. https://doi.org/10.1177/082585979100700202
  • Castelli, L., Elter, T., Wolf, F., Watson, M., Schenk, A., Steindorf, K., . . . Zimmer, P. (2022). Sleep problems and their interaction with physical activity and fatigue in hematological cancer patients during onset of high dose chemotherapy. Supportive Care in Cancer, 30(1), 167-176. https://doi.org/10.1007/s00520-021-06377-5
  • Chen, F., Leng, Y., Zhang, L., Xu, J., Zhang, D., Qin, Y., ... & Zheng, Y. (2021). The correlation of symptom clusters and functional performance in adult acute leukemia patients under chemotherapy. Cancer Nursing, 44(5), E287-E295. https://doi.org/10.1097/NCC.0000000000000816.
  • Crossnohere, N. L., R., R. D., Crystal, R., Bernadette, O. D., M., L. S., Douglas, S. B., & and Bridges, J. F. P. (2019). Side effects from acute myeloid leukemia treatment: results from a national survey. Current Medical Research and Opinion, 35(11), 1965-1970. https://doi.org/10.1080/03007995.2019.1631149
  • Çakmak, S., & Nural, N. (2019). Incidence of and risk factors for development of oral mucositis in outpatients undergoing cancer chemotherapy. Int J Nurs Pract, 25(1), e12710. https://doi.org/10.1111/ijn.12710
  • Ebert, R. P., Magnus, M. M., Toro, P., Manoel, F. G., Costa, F. F., Olalla Saad, S. T., & de Melo Campos, P. (2023). Hematologic malignancies patients face high symptom burden and are lately referred to palliative consultation: analysis of a single center experience. American Journal of Hospice and Palliative Medicine®, 40(7), 761-764.
  • Kevin, M.S. (2023). Statistics. Retrieved from https://www.openepi.com/SampleSize/SSCohort.htm.
  • Hall, A. E., Sanson-Fisher, R. W., Lynagh, M. C., Tzelepis, F., & D’Este, C. (2015). What do haematological cancer survivors want help with? A cross-sectional investigation of unmet supportive care needs. BMC Research Notes, 8(1). https://doi.org/10.1186/s13104-015-1188-7
  • Hassan, B. A. R. (2025). Assessing chemotherapy-induced nausea and vomiting in breast cancer patients in Malaysia: Insights into quality of life and genetic influences. Middle Eastern Cancer and Oncology Journal, 1(1), 23-29.
  • Hofmann, W. K., Trumpp, A., & Müller‐Tidow, C. (2023). Therapy resistance mechanisms in hematological malignancies. International Journal of Cancer, 152(3), 340-347.
  • Konstantinidis, T. I., Tsatsou, I., Tsagkaraki, E., Chasouraki, E., Saridi, M., Adamakidou, T., & Govina, O. (2024). Quality of life and symptoms of hospitalized hematological cancer patients. Current Oncology, 31(11), 6699-6710. https://doi.org/10.3390/curroncol31110494
  • Kottschade, L., Novotny, P., Lyss, A., Mazurczak, M., Loprinzi, C., & Barton, D. (2016). Chemotherapy-induced nausea and vomiting: incidence and characteristics of persistent symptoms and future directions NCCTG N08C3 (Alliance). Supportive Care in Cancer, 24(6), 2661-2667. https://doi.org/10.1007/s00520-016-3080-y
  • Lalla, R. V., Brennan, M. T., Gordon, S. M., Sonis, S. T., Rosenthal, D. I., & Keefe, D. M. (2019). Oral mucositis due to high-dose chemotherapy and/or head and neck radiation therapy. JNCI Monographs, 2019(53), lgz011.
  • LeBlanc, T. W., Wolf, S. P., El-Jawahri, A., Davis, D. M., Locke, S. C., & Abernethy, A. (2015). Symptom burden, quality of life, and distress in acute myeloid leukemia patients receiving induction chemotherapy: results of a prospective electronic patient-reported outcomes study. Blood, 126(23), 4496. https://doi.org/10.1182/blood.V126.23.4496.4496
  • Lewandowska, A., Rudzki, G., Lewandowski, T., Próchnicki, M., Rudzki, S., Laskowska, B., & Brudniak, J. (2020). Quality of life of cancer patients treated with chemotherapy. International Journal of Environmental Research and Public Health, 17(19), 6938.
  • Miladinia, M., Baraz, S., Ramezani, M., & Malehi, A. S. (2018). The relationship between pain, fatigue, sleep disorders and quality of life in adult patients with acute leukaemia: During the first year after diagnosis. European Journal of Cancer Care, 27(1), e12762. https://doi.org/10.1111/ecc.12762
  • Naito, Y., Kai, Y., Ishikawa, T., Fujita, T., Uehara, K., Doihara, H., . . . Saeki, T. (2020). Chemotherapy-induced nausea and vomiting in patients with breast cancer: A prospective cohort study. Breast Cancer, 27(1), 122-128. https://doi.org/10.1007/s12282-019-01001-1
  • Nayak, M. G., George, A., Vidyasagar, M. S., Mathew, S., Nayak, S., Nayak, B. S., . . . Kamath, A. (2017). Quality of life among cancer patients. Indian Journal of Palliative Care, 23(4), 445-450. https://doi.org/10.4103/ijpc.Ijpc_82_17
  • Noyan, S., Gündogdu, F., & Bozdağ, S. C. (2023). The level of fatigue, insomnia, depression, anxiety, stress, and the relationship between these symptoms following allogeneic hematopoietic stem cell transplantation: a cross-sectional study. Supportive Care in Cancer, 31(4). https://doi.org/10.1007/s00520-023-07703-9
  • Sadırlı, S. K. (2008). Kanserli hastalarda semptom kontrolünün değerlendirilmesi (Yüksek lisans tezi). Trakya Üniversitesi, Sağlık Bilimleri Enstitüsü, Hemşirelik Anabilim Dalı, Edirne.
  • Serbest, Z., & Sayar, S. (2023). Kemoterapi alan kanser hastalarında stres yaratan durumlar ve stresle baş etme stratejileri: Tanımlayıcı ve kesitsel bir çalışma. Turkiye Klinikleri Journal of Nursing Sciences, 15(3), 810-821.
  • Seven, M., Akyüz, A., Sever, N., ve Dinçer, Ş. (2013). Kanser tanısı alan hastaların yaşadığı fiziksel ve psikolojik semptomların belirlenmesi. TAF Preventive Medicine Bulletin, 12(3), 219-224. doi:10.5455/pmb.1-1343053458
  • Shaulov, A., Rodin, G., Popovic, G., Caraiscos, V. B., Le, L. W., Rydall, A., . . . Zimmermann, C. (2019). Pain in patients with newly diagnosed or relapsed acute leukemia. Supportive Care in Cancer, 27(8), 2789-2797. https://doi.org/10.1007/s00520-018-4583-5
  • Siddika, S. S., Rahman, M. A., Islam, A. M., Siddika, S. T., Akhtar, K., & Siddika, A. (2020). Symptom burden of patients with haematological malignancy. Bangladesh Medical Research Council Bulletin, 46(3), 196-203.
  • Song, J., Yu, H., & Ryu, E. (2025). Comparative analysis of chemotherapy‐induced oral mucositis, nutritional status, and depression in patients with acute leukemia. European Journal of Cancer Care, 2025(1), 7989087.
  • Stolze, J., Vlaanderen, K. C. E., Raber-Durlacher, J. E., & Brand, H. S. (2020). The impact of hematological malignancies and their treatment on oral health-related quality of life as assessed by the OHIP-14: A systematic review. Odontology, 108(3), 511-520. https://doi.org/10.1007/s10266-019-00479-7
  • Şentürk, B., Ünlü, F., Dündar, S., Kavak Ergün, A., Sevinç, A., & Tütüncü, S. (2025). Türkiye Kanser İstatistikleri 2020.
  • Wang, X. S., Zhao, F., Fisch, M. J., O'Mara, A. M., Cella, D., Mendoza, T. R., & Cleeland, C. S. (2014). Prevalence and characteristics of moderate to severe fatigue: A multicenter study in cancer patients and survivors. Cancer, 120(3), 425-432. doi:10.1002/cncr.28434
  • Wang, Y., & Feng, W. (2022). Cancer-related psychosocial challenges. General Psychiatry, 35(5), e100871.
  • Ziętarska, M., Krawczyk-Lipiec, J., Kraj, L., Zaucha, R., & Małgorzewicz, S. (2017). Chemotherapy-related toxicity, nutritional status and quality of life in precachectic oncologic patients with, or without, high protein nutritional support. A prospective, randomized study. Nutrients, 9(10), 1108. https://doi.org/10.3390/nu9101108.
  • Zimmermann, C., Yuen, D., Mischitelle, A., Minden, M. D., Brandwein, J. M., Schimmer, A., . . . Rodin, G. (2013). Symptom burden and supportive care in patients with acute leukemia. Leukemia Research, 37(7), 731-736. https://doi.org/10.1016/j.leukres.2013.02.009.

Evaluation of Symptoms Experienced by Patients Receiving High-Dose Chemotherapy

Year 2026, Volume: 15 Issue: 1 , 145 - 154 , 28.02.2026
https://doi.org/10.53424/balikesirsbd.1739967
https://izlik.org/JA32JC29GT

Abstract

Objective: The aim of this study is to determine the symptoms experienced by hematological cancer patients receiving high-dose chemotherapy. Materials and Methods: This descriptive cross-sectional study was conducted with 158 patients receiving treatment at the hematology clinic of a university hospital. Data were collected using a personal information form and the “Edmonton Symptom Assessment System”. Results: The mean age of the patients included in the study was 45.37±13.24 years and 51.9% were female. It was determined that the patients experienced fatigue (76.6%), anorexia (66.5%), pain (48.7%) and sadness (48.7%) as the most common symptoms, respectively. In particular, the first week mean scores of many symptoms (pain, fatigue, nausea, insomnia, loss of appetite, feeling of well-being, shortness of breath, changes in skin and nails, stomatite or sore mouth) were found to be significantly higher than those before treatment and/or in the second week (p<0.05). Conclusion: In conclusion, fatigue, anorexia, pain and sadness were the most common symptoms in patients receiving high-dose chemotherapy, and the severity of many symptoms increased especially in the first week. Based on these findings, it is recommended that nurses closely assess symptoms in the early phase of treatment, implement proactive symptom management strategies, and develop individualized care plans.

Ethical Statement

Institution: Gümüshane University Scientific Research Ethics Committee Date: 28.02.2023 Approval no: E-95674917-108.99-164417

Supporting Institution

This study did not receive any financial support from individuals or organizations.

Thanks

The authors sincerely thank all individuals who contributed to this study.

References

  • Akin, S., & Durna, Z. (2013). A comparative descriptive study examining the perceptions of cancer patients, family caregivers, and nurses on patient symptom severity in Turkey. European Journal of Oncology Nursing, 17(1), 30-37. https://doi.org/10.1016/j.ejon.2012.02.002
  • Allart-Vorelli, P., Porro, B., Baguet, F., Michel, A., & Cousson-Gélie, F. (2015). Haematological cancer and quality of life: a systematic literature review. Blood Cancer Journal, 5(4), e305-e305. https://doi.org/10.1038/bcj.2015.29
  • Arpacı, F. (2004). Yüksek doz kemoterapi ve radyoterapi uygulaması. Türk Hematoloji Derneği Kan ve Kemik İliği Transplantasyonu Kursu.
  • Bruera, É., Kuehn, N., Miller, M. J., Selmser, P., & Macmillan, K. (1991). The Edmonton symptom assessment system (ESAS): A simple method for the assessment of palliative care patients. Journal of Palliative Care, 7(2), 6-9. https://doi.org/10.1177/082585979100700202
  • Castelli, L., Elter, T., Wolf, F., Watson, M., Schenk, A., Steindorf, K., . . . Zimmer, P. (2022). Sleep problems and their interaction with physical activity and fatigue in hematological cancer patients during onset of high dose chemotherapy. Supportive Care in Cancer, 30(1), 167-176. https://doi.org/10.1007/s00520-021-06377-5
  • Chen, F., Leng, Y., Zhang, L., Xu, J., Zhang, D., Qin, Y., ... & Zheng, Y. (2021). The correlation of symptom clusters and functional performance in adult acute leukemia patients under chemotherapy. Cancer Nursing, 44(5), E287-E295. https://doi.org/10.1097/NCC.0000000000000816.
  • Crossnohere, N. L., R., R. D., Crystal, R., Bernadette, O. D., M., L. S., Douglas, S. B., & and Bridges, J. F. P. (2019). Side effects from acute myeloid leukemia treatment: results from a national survey. Current Medical Research and Opinion, 35(11), 1965-1970. https://doi.org/10.1080/03007995.2019.1631149
  • Çakmak, S., & Nural, N. (2019). Incidence of and risk factors for development of oral mucositis in outpatients undergoing cancer chemotherapy. Int J Nurs Pract, 25(1), e12710. https://doi.org/10.1111/ijn.12710
  • Ebert, R. P., Magnus, M. M., Toro, P., Manoel, F. G., Costa, F. F., Olalla Saad, S. T., & de Melo Campos, P. (2023). Hematologic malignancies patients face high symptom burden and are lately referred to palliative consultation: analysis of a single center experience. American Journal of Hospice and Palliative Medicine®, 40(7), 761-764.
  • Kevin, M.S. (2023). Statistics. Retrieved from https://www.openepi.com/SampleSize/SSCohort.htm.
  • Hall, A. E., Sanson-Fisher, R. W., Lynagh, M. C., Tzelepis, F., & D’Este, C. (2015). What do haematological cancer survivors want help with? A cross-sectional investigation of unmet supportive care needs. BMC Research Notes, 8(1). https://doi.org/10.1186/s13104-015-1188-7
  • Hassan, B. A. R. (2025). Assessing chemotherapy-induced nausea and vomiting in breast cancer patients in Malaysia: Insights into quality of life and genetic influences. Middle Eastern Cancer and Oncology Journal, 1(1), 23-29.
  • Hofmann, W. K., Trumpp, A., & Müller‐Tidow, C. (2023). Therapy resistance mechanisms in hematological malignancies. International Journal of Cancer, 152(3), 340-347.
  • Konstantinidis, T. I., Tsatsou, I., Tsagkaraki, E., Chasouraki, E., Saridi, M., Adamakidou, T., & Govina, O. (2024). Quality of life and symptoms of hospitalized hematological cancer patients. Current Oncology, 31(11), 6699-6710. https://doi.org/10.3390/curroncol31110494
  • Kottschade, L., Novotny, P., Lyss, A., Mazurczak, M., Loprinzi, C., & Barton, D. (2016). Chemotherapy-induced nausea and vomiting: incidence and characteristics of persistent symptoms and future directions NCCTG N08C3 (Alliance). Supportive Care in Cancer, 24(6), 2661-2667. https://doi.org/10.1007/s00520-016-3080-y
  • Lalla, R. V., Brennan, M. T., Gordon, S. M., Sonis, S. T., Rosenthal, D. I., & Keefe, D. M. (2019). Oral mucositis due to high-dose chemotherapy and/or head and neck radiation therapy. JNCI Monographs, 2019(53), lgz011.
  • LeBlanc, T. W., Wolf, S. P., El-Jawahri, A., Davis, D. M., Locke, S. C., & Abernethy, A. (2015). Symptom burden, quality of life, and distress in acute myeloid leukemia patients receiving induction chemotherapy: results of a prospective electronic patient-reported outcomes study. Blood, 126(23), 4496. https://doi.org/10.1182/blood.V126.23.4496.4496
  • Lewandowska, A., Rudzki, G., Lewandowski, T., Próchnicki, M., Rudzki, S., Laskowska, B., & Brudniak, J. (2020). Quality of life of cancer patients treated with chemotherapy. International Journal of Environmental Research and Public Health, 17(19), 6938.
  • Miladinia, M., Baraz, S., Ramezani, M., & Malehi, A. S. (2018). The relationship between pain, fatigue, sleep disorders and quality of life in adult patients with acute leukaemia: During the first year after diagnosis. European Journal of Cancer Care, 27(1), e12762. https://doi.org/10.1111/ecc.12762
  • Naito, Y., Kai, Y., Ishikawa, T., Fujita, T., Uehara, K., Doihara, H., . . . Saeki, T. (2020). Chemotherapy-induced nausea and vomiting in patients with breast cancer: A prospective cohort study. Breast Cancer, 27(1), 122-128. https://doi.org/10.1007/s12282-019-01001-1
  • Nayak, M. G., George, A., Vidyasagar, M. S., Mathew, S., Nayak, S., Nayak, B. S., . . . Kamath, A. (2017). Quality of life among cancer patients. Indian Journal of Palliative Care, 23(4), 445-450. https://doi.org/10.4103/ijpc.Ijpc_82_17
  • Noyan, S., Gündogdu, F., & Bozdağ, S. C. (2023). The level of fatigue, insomnia, depression, anxiety, stress, and the relationship between these symptoms following allogeneic hematopoietic stem cell transplantation: a cross-sectional study. Supportive Care in Cancer, 31(4). https://doi.org/10.1007/s00520-023-07703-9
  • Sadırlı, S. K. (2008). Kanserli hastalarda semptom kontrolünün değerlendirilmesi (Yüksek lisans tezi). Trakya Üniversitesi, Sağlık Bilimleri Enstitüsü, Hemşirelik Anabilim Dalı, Edirne.
  • Serbest, Z., & Sayar, S. (2023). Kemoterapi alan kanser hastalarında stres yaratan durumlar ve stresle baş etme stratejileri: Tanımlayıcı ve kesitsel bir çalışma. Turkiye Klinikleri Journal of Nursing Sciences, 15(3), 810-821.
  • Seven, M., Akyüz, A., Sever, N., ve Dinçer, Ş. (2013). Kanser tanısı alan hastaların yaşadığı fiziksel ve psikolojik semptomların belirlenmesi. TAF Preventive Medicine Bulletin, 12(3), 219-224. doi:10.5455/pmb.1-1343053458
  • Shaulov, A., Rodin, G., Popovic, G., Caraiscos, V. B., Le, L. W., Rydall, A., . . . Zimmermann, C. (2019). Pain in patients with newly diagnosed or relapsed acute leukemia. Supportive Care in Cancer, 27(8), 2789-2797. https://doi.org/10.1007/s00520-018-4583-5
  • Siddika, S. S., Rahman, M. A., Islam, A. M., Siddika, S. T., Akhtar, K., & Siddika, A. (2020). Symptom burden of patients with haematological malignancy. Bangladesh Medical Research Council Bulletin, 46(3), 196-203.
  • Song, J., Yu, H., & Ryu, E. (2025). Comparative analysis of chemotherapy‐induced oral mucositis, nutritional status, and depression in patients with acute leukemia. European Journal of Cancer Care, 2025(1), 7989087.
  • Stolze, J., Vlaanderen, K. C. E., Raber-Durlacher, J. E., & Brand, H. S. (2020). The impact of hematological malignancies and their treatment on oral health-related quality of life as assessed by the OHIP-14: A systematic review. Odontology, 108(3), 511-520. https://doi.org/10.1007/s10266-019-00479-7
  • Şentürk, B., Ünlü, F., Dündar, S., Kavak Ergün, A., Sevinç, A., & Tütüncü, S. (2025). Türkiye Kanser İstatistikleri 2020.
  • Wang, X. S., Zhao, F., Fisch, M. J., O'Mara, A. M., Cella, D., Mendoza, T. R., & Cleeland, C. S. (2014). Prevalence and characteristics of moderate to severe fatigue: A multicenter study in cancer patients and survivors. Cancer, 120(3), 425-432. doi:10.1002/cncr.28434
  • Wang, Y., & Feng, W. (2022). Cancer-related psychosocial challenges. General Psychiatry, 35(5), e100871.
  • Ziętarska, M., Krawczyk-Lipiec, J., Kraj, L., Zaucha, R., & Małgorzewicz, S. (2017). Chemotherapy-related toxicity, nutritional status and quality of life in precachectic oncologic patients with, or without, high protein nutritional support. A prospective, randomized study. Nutrients, 9(10), 1108. https://doi.org/10.3390/nu9101108.
  • Zimmermann, C., Yuen, D., Mischitelle, A., Minden, M. D., Brandwein, J. M., Schimmer, A., . . . Rodin, G. (2013). Symptom burden and supportive care in patients with acute leukemia. Leukemia Research, 37(7), 731-736. https://doi.org/10.1016/j.leukres.2013.02.009.
There are 34 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases Nursing​
Journal Section Research Article
Authors

Seher Çakmak 0000-0003-4684-8333

Nesrin Nural 0000-0003-2100-7386

Submission Date July 11, 2025
Acceptance Date January 6, 2026
Publication Date February 28, 2026
DOI https://doi.org/10.53424/balikesirsbd.1739967
IZ https://izlik.org/JA32JC29GT
Published in Issue Year 2026 Volume: 15 Issue: 1

Cite

APA Çakmak, S., & Nural, N. (2026). Evaluation of Symptoms Experienced by Patients Receiving High-Dose Chemotherapy. Balıkesir Sağlık Bilimleri Dergisi, 15(1), 145-154. https://doi.org/10.53424/balikesirsbd.1739967

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