Objective and subjective physical function in allogeneic hematopoietic stem cell transplant recipients

Area of Science:

• Hematology
• Transplantation Medicine
• Rehabilitation Science

Background:

• Adult allogeneic hematopoietic cell transplantation (HCT) recipients often experience physical deconditioning.
• Assessing pre- and post-transplant physical function is crucial for understanding patient outcomes.

Purpose of the Study:

• To prospectively evaluate physical function in adult allogeneic HCT recipients.
• To determine the association between physical function metrics and survival post-HCT.

Main Methods:

• Prospective study involving 47 adult allogeneic HCT recipients.
• Utilized wrist actigraphy, 6-minute walk test (6MWT), International Physical Activity Questionnaire (IPAQ), and FACT-BMT.
• Serial assessments of 6MWT, IPAQ, and FACT-BMT were conducted post-HCT.

Main Results:

• No vigorous activity observed via actigraphy; patients were sedentary for a median of 6 hours daily.
• Pre-HCT IPAQ showed light (36%), moderate (43%), and vigorous (21%) activity levels.
• Post-HCT 6MWT at day +30 showed the strongest association with survival and non-relapse mortality.
• Declining 6MWT distance correlated with worsened overall survival.

Conclusions:

• Physical fitness assessments are feasible in HCT recipients.
• The 6MWT at day +30 post-HCT and changes from baseline can risk-stratify for mortality.
• These findings highlight the potential for targeted interventions to improve outcomes.