Background: During pediatric hematopoietic stem cell transplant (HSCT), there is significant reduction in physical activity, leading to loss of strength and function, along with decline in quality of life (QoL). This study evaluates the effects of a supervised exercise program on functional ability, mobility, strength, and QoL during and following pediatric HSCT.Methods: Patients ages 4-21 years presenting for HSCT were randomized to either an intervention group, who underwent exercise routines three times weekly and once weekly on discharge for 6 weeks supervised by a physical therapist, or the control group, which was treated per standard of care. Forty subjects were recruited for the study, 20 in each arm. Physical therapy and QoL assessments were conducted at three time points: pre-HSCT (baseline), on the day of hospital discharge, and 6 weeks after discharge.Results: Exercise capacity and endurance using Six-Minute Walk test (p = .023) and strength using manual muscle testing (p = .005) were improved in the exercise group, compared to the control group. There was evidence that some QoL outcomes (measured using the Patient Reported Outcomes Measurement Information System) were improved 6 weeks post discharge, with observed decreases in anxiety (p = .0009) and fatigue (p = .037). Conclusion:Supervised exercise program during pediatric HSCT has positive effects on endurance, functional mobility, and muscle strength, and may also result in improvements in some aspects of QoL. This trial was registered at www.clinicaltrials.gov as NCT04663503.

The novel coronavirus (COVID-19) has continued its global spread since the first documented case in late 2019 in Wuhan, China. With over 10 million cases and 500 thousand deaths reported worldwide, the need for an effective treatment regimen is evident. Historically, convalescent plasma (CP) has been utilized in the treatment of viral respiratory pathogens. Critically ill patients with COVID-19 in China and South Korea have been treated with CP given the ineffectiveness of experimental therapies with antivirals alone. This commentary explores the importance of published experience and the pending establishment of efficacy to facilitate an informed decision regarding the therapeutic use of CP. With increasing mortality around the world from COVID-19 infection, the need for alternative, effective treatment regimens is critical.