Abstract
Background: Persistent fatigue is one of the most common and burdensome late effects in childhood cancer survivors (CCS), yet its mechanisms remain poorly understood.
Methods: This PhD combined longitudinal surveys, physical fitness testing, blood biomarkers, and real-time ecological momentary assessment with wearable monitoring in adolescent and young adult CCS, with comparisons to healthy controls.
Results: Fatigue was highly prevalent, multidimensional, and fluctuated markedly over time. Psychological distress, poor sleep, and reduced physical fitness were key modifiable contributors. Biomarker analyses revealed biological alterations and two distinct subgroups, underscoring fatigue heterogeneity.
Conclusion: Fatigue in CCS is a dynamic, multifactorial condition requiring systematic screening and personalized, multidisciplinary care.