Factors affecting lower limb muscle strength and cardiopulmonary fitness after allogeneic hematopoietic stem cell transplantation

Ishikawa, Akio; Otaka, Yohei; Kamisako, Michiyo; Suzuki, Tetsuya; Miyata, Chieko; Tsuji, Takao; Matsumoto, Hideo; Kato, Jun; Mori, Takehiko; Okamoto, Shinichiro; Liu, Meigen

doi:10.1007/s00520-018-4433-5

Cited by 32 publications

(29 citation statements)

References 40 publications

(41 reference statements)

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“…Acute GVHD after allogeneic HSCT has been reported to suppress physical function after transplantation [2,15,16]. However, there is no report that examines the influence of differences in the severity of acute GVHD on the clinical courses and physical function after transplantation in detail.…”

Section: Discussionmentioning

confidence: 99%

Effect of the severity of acute graft-versus-host disease on physical function after allogeneic hematopoietic stem cell transplantation

Hamada

Kondo

Murao

et al. 2019

Support Care Cancer

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The purpose of this study was to retrospectively investigate the effect of the severity of acute graft-versus-host disease (acute GVHD) on physical function after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods 76 patients were included as subjects of this study. Severity of acute GVHD was classified according to the method defined by Grucksberg. To evaluate physical function, the knee extensor strength and six-minute walk distance (6MWD) were performed. Results Among these patients, 54% developed acute GVHD; of these 32%, 54%, and 15% of patients had Grade I, Grade II, and Grade III-IV GVHD, respectively. In the Grade I-II groups, mild acute GVHD following allo-HSCT, resulted in a gradual decline in physical function, which improved at discharge. However, in cases of severe acute GVHD, physical function deteriorated, implementation of rehabilitation became difficult, and the decline in physical function persisted even at discharge. Conclusion These results indicate that severe acute GVHD negatively affects physical function leading to longer hospital days because of inadequate rehabilitation interventions.

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Section: Discussionmentioning

confidence: 99%

Effect of the severity of acute graft-versus-host disease on physical function after allogeneic hematopoietic stem cell transplantation

Hamada

Kondo

Murao

et al. 2019

Support Care Cancer

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Section: Physical Function Before Allo-hsct or Hospital Admissionmentioning

confidence: 99%

“…Another report showed that factors significantly associated with reduced leg extension strength after allo-HSCT included pre-procedure leg extension strength, grade of acute GVHD, age, and time interval between pre-and post-evaluation in 88 patients who received allo-HSCT 22 . Patient leg extension strength and peak VO 2 were significantly reduced after allo-HSCT 22 . Another study showed that both allogeneic (n = 11) and autologous (n = 11) HSCT patients with lower peak VO 2 had higher symptom burdens and inferior QOL during the early post-HSCT period 23 .…”

Section: Physical Function Before Allo-hsct or Hospital Admissionmentioning

confidence: 99%

The Benefit of Exercise in Patients Who Undergo Allogeneic Hematopoietic Stem Cell Transplantation

Morishita

Tsubaki

Hotta

et al. 2019

The Journal of the International Society of Physical and Rehabilitation Medicine

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Allogeneic hematopoietic stem-cell transplantation (allo-HSCT) is increasingly used in the treatment of hematologic cancers such as leukemias, lymphomas, and myeloma, and for other hematologic disorders such as primary immunodeficiency, aplastic anemia, and myelodysplasia. Allo-HSCT entails a conditioning regimen of frequent high-dose chemotherapy in combination with total body irradiation, followed by infusion of donor-harvested bone marrow or peripheral blood stem cells. As an aggressive and demanding medical therapy that profoundly impacts patient quality of life (QOL), allo-HSCT is associated with numerous treatment-related physical, psychological, and psychosocial side effects. The procedure can result in decreased respiratory and balance function, skeletal muscle strength, and exercise capacity. Thus, as physical exercise has been shown to positively effect physical and psychosocial function and QOL in allo-HSCT patients, it is a recommended intervention for improving essential functions and offsetting lost exercise capacity after the procedure. Furthermore, recent evidence has shown that physical exercise can influence survival rate and mortality in allo-HSCT patients. This review provides an overview of the current research on the effectiveness of physical exercise for allo-HSCT patients.

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“…Advancement in allo-HSCT conditioning regimens, treatments for opportunistic infectious complications, and management of graft versus host disease (GVHD) have improved the five-year net survival rate for blood-related cancers [ 1 ]. Unfortunately, allo-HSCT patients experience significant reductions in physical capacity as a result of pre-transplant conditioning regimens [ 2 , 3 , 4 , 5 ] and post-transplant comorbidities [ 6 ] that are associated with reduced psychological wellbeing [ 7 , 8 ], survival [ 9 , 10 ], and short- and long-term health-related quality of life (HRQOL) [ 11 , 12 ]. Compounding this, physical capacity is further impacted by prolonged physical inactivity during hospital stays [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Exercise before, during, and after Hospitalization for Allogeneic Hematological Stem Cell Transplant: A Feasibility Randomized Controlled Trial

Mina

Dolan

Lipton

et al. 2020

JCM

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People with cancer who undergo allogeneic hematological stem cell transplant (allo-HSCT) experience significant deconditioning that can compromise quality of life. Exercise has shown to be beneficial before or after allo-HSCT; however, little is known about exercise therapy delivered across the continuum of care. We conducted a feasibility randomized controlled trial of exercise delivered prior to admission, during the inpatient stay, and after discharge versus control in people with planned allo-HSCT. Feasibility was assessed via recruitment and retention rates, the incidence of adverse events, and adherence to the exercise prescription. Estimates of efficacy were measured at baseline, one week prior to hospital admission, and 100 days and one year after transplant. The recruitment and retention rates were 20% and 33%, respectively. One serious adverse event occurred during the baseline six-minute walk test that precluded participation in the study and no adverse events were associated with the intervention. From baseline to pre-transplant, the intervention group improved six-minute walk test distances by 45 m (95% CI: −18.0 to 108.7)—a finding that warrants further investigation with an adequately powered trial. Our study contributes important feasibility considerations and pilot data for future exercise intervention research in allo-HSCT recipients.

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Factors affecting lower limb muscle strength and cardiopulmonary fitness after allogeneic hematopoietic stem cell transplantation

Abstract: These findings suggest that improvements in muscle strength and cardiopulmonary fitness before HSCT are crucial for maintaining post-treatment physical function, especially in elderly individuals with acute GVHD requiring a long-term stay in a protective environment.

Cited by 32 publications

References 40 publications

Effect of the severity of acute graft-versus-host disease on physical function after allogeneic hematopoietic stem cell transplantation

Effect of the severity of acute graft-versus-host disease on physical function after allogeneic hematopoietic stem cell transplantation

The Benefit of Exercise in Patients Who Undergo Allogeneic Hematopoietic Stem Cell Transplantation

Exercise before, during, and after Hospitalization for Allogeneic Hematological Stem Cell Transplant: A Feasibility Randomized Controlled Trial

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