Pre-HSCT Conditioning May Improve Physical Functioning in Hematologic Cancers

Improving muscle strength and cardiopulmonary fitness prior to undergoing allogeneic hematopoietic stem cell transplantation (HSCT) may be important to maintaining physical function post-procedure among patients with hematologic malignancies, according to a study published in Supportive Care in Cancer.

There is a reduction of physical function after HSCT, which is attributable to decreased physical activity and toxicity. Previous studies assessing the effect of exercise, however, have shown that in spite of these interventions there is functional decline among this patient population; which factors are associated with post-HSCT physical function is important for future management strategies.

For this retrospective study, researchers assessed the outcomes of 88 patients with hematologic disease (leukemia, lymphoma, multiple myeloma, aplastic anemia) who underwent HSCT. Baseline evaluations of leg extension torque and peak oxygen consumption (VO₂) were performed before and after HSCT.  Patient factors and transplant factors were also evaluated.

Results showed that patients had significant reductions in leg extension torque and peak VO₂ after HSCT (P < .001).

Significant factors associated with reduced post-HSCT leg extension torque were pre-HSCT leg extension torque, grades of acute graft-versus-host disease (GVHD), age, and the interval between pre- and post-evaluation.

The only factor significantly associated with post-HSCT peak VO₂ was its value prior to HSCT.

Improving physical and cardiopulmonary fitness prior to HSCT may help patients maintain physical function after the procedure. The authors concluded that it is important patients start “rehabilitation earlier before HSCT. Our study also suggests that careful consideration should be paid to lower limb muscle strength, especially in elderly individuals who are developing acute GVHD and those who are staying in a protective environment long-term.”

Reference

Ishikawa A, Otaka Y, Kamisako M, et al. Factors affecting lower limb muscle strength and cardiopulmonary fitness after allogeneic hematopoietic stem cell transplantation [published online August 28, 2018]. Support Care Cancer. doi: 10.1007/s00520-018-4433-5