本研究旨在更新《癌症儿童和青少年疲劳管理的临床实践指南（CPG）》或儿科造血干细胞移植接受者的指南。我们重新召集了一个多学科和多国籍的专家组。与之前的2018年CPG评估成人和儿童随机对照试验（RCT）管理疲劳相比，此2023更新仅基于儿童RCT修订了上述的推荐。在更新的系统回顾中包含了20个RCT。体力活动明显减轻了疲劳（标准化平均差异-0.44，95％置信区间-0.64至-0.24，n＝8个RCT）。基于2018年的建议，专家组继续强烈推荐在儿科患者中使用体力活动，并提供放松、正念或两者结合来管理疲劳。可以提供认知或认知行为疗法。药物治疗不应常规使用。专家组制定了一个新的良好实践声明，建议常规评估疲劳情况，理想情况下使用经过验证的评估工具。© 2023作者。

Objective was to update a clinical practice guideline (CPG) for the management of fatigue in children and adolescents with cancer or pediatric hematopoietic cell transplant recipients. We reconvened a multi-disciplinary and multi-national panel. While the previous 2018 CPG evaluated adult and pediatric randomized controlled trials (RCTs) to manage fatigue, this 2023 update revised previous recommendations based only on pediatric RCTs. Twenty RCTs were included in the updated systematic review. Physical activity significantly reduced fatigue (standardized mean difference -0.44, 95% confidence interval -0.64 to -0.24; n = 8 RCTs). Using the 2018 recommendations as a basis, the panel continued to make strong recommendations to use physical activity, and to offer relaxation, mindfulness or both, to manage fatigue in pediatric patients. Cognitive or cognitive behavioral therapies may be offered. Pharmacological approaches should not be routinely used. The panel made a new good practice statement to routinely assess for fatigue, ideally using a validated scale.© 2023 The Author(s).