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Updated: Jun 23, 2025
Competitive Transplants to Evaluate Hematopoietic Stem Cell Fitness
Published on: August 31, 2016
Severely reduced physical performance is already present at the time of admission for stem cell transplantation
Ronja Beller1, Gabriele Gauß1, Oliver Basu1
1Clinics for Paediatrics III, Department of Paediatric Haematology/Oncology, West German Cancer Centre, University Hospital Essen, Essen, Germany.
Insights
Children undergoing allogeneic haematopoietic stem cell transplantation (allo-HSCT) show significantly lower fitness levels. Structured exercise programs are recommended to improve physical condition before this intensive cancer treatment.
Area of Science:
- Pediatric Oncology
- Exercise Physiology
- Transplantation Medicine
Background:
- Allogeneic haematopoietic stem cell transplantation (allo-HSCT) in pediatric cancer patients carries a high risk of infections and complications.
- Optimizing physical condition prior to allo-HSCT is crucial for better outcomes.
- This study evaluates the fitness status of pediatric patients before undergoing allo-HSCT.
Purpose of the Study:
- To assess the fitness status of pediatric cancer patients before allo-HSCT.
- To identify correlations between fitness, quality of life, fatigue, clinical data, and prior exercise.
- To compare the fitness of these patients with healthy children.
Main Methods:
- The ANIMAL trial recruited pediatric cancer patients (≥4 years) for allo-HSCT.
- Assessments included clinical data, anthropometrics, motor performance (strength, endurance, balance), and psychological parameters.
- Fitness values were compared to normative data from healthy children, with correlation analyses performed.
Main Results:
- 22 pediatric patients showed significantly reduced motor performance compared to reference values (e.g., -106% in static stance, -48% in hand grip strength).
- Correlations were found between age and fitness, inpatient days and fatigue.
- Previous exercise sessions correlated with improved hand grip strength.
Conclusions:
- Pediatric patients awaiting HSCT exhibit poorer fitness than healthy peers.
- Structured exercise programs are recommended for children undergoing HSCT.
- Individualized training is important, highlighting the positive impact of exercise on strength.
Objectives:
Paediatric patients with cancer undergoing allogeneic haematopoietic stem cell transplantation (allo-HSCT) face a high risk for life-threatening infections and transplant-related complications. Therefore, these children should be in the best possible physical condition beforehand. The study aims to evaluate the fitness status before allo-HSCT and identify correlations between fitness, quality of life and fatigue, clinical data, and previous exercise sessions.
Methods:
Paediatric patients with cancer ≥4 years old, treated with allo-HSCT, were recruited for the ANIMAL trial ("Effects of a low vs. moderate intense exercise program on immune recovery during paediatric allo-HSCT.", DRKS ID:DRKS00019865). Assessed at admission for HSCT were (1) clinical and anthropometric data, (2) motor performance (strength, endurance and balance) and (3) psychological parameters. Values were compared with published reference values (normative data from the literature) of healthy children, and correlation analyses were conducted.
Results:
22 paediatric patients undergoing pre-allo-HSCT (23% female, 9.4±4.5 years, 73% leukaemia) exhibited substantial reduced differences in all motor performance parameters, with up to -106%±98 (mean difference to reference value) in static stance, -37%±45 in sit-to-stand, -52%±16 in leg extension and -48%±22 in hand grip strength compared with reference values. Correlations were observed among age and fitness parameters, the number of inpatient days and fatigue, and many previous exercise sessions correlated with better hand grip strength.
Conclusion:
These results indicate a poorer fitness status in children before HSCT compared with healthy children, recommending the need for structured exercise programmes for children undergoing HSCT. Differently directed correlations between age/body mass index and endurance/strength and between exercise sessions and strength show the importance of individualised training recommendations and the effect of training.
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