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Preventing Allogeneic Stem Cell Transplant-Related Cardiovascular Dysfunction: ALLO-Active Trial.

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A multicomponent activity program improved cardiorespiratory fitness and exercise cardiac function in patients undergoing allogeneic stem cell transplantation (allo-SCT). This intervention helps preserve fitness and cardiac function post-transplant.

Keywords:
cardiac imaging techniquescardio-oncologycardiorespiratory fitnesscardiotoxicityexercisehematologic neoplasmsprimary prevention

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Area of Science:

  • Cardiology
  • Hematology
  • Exercise Physiology

Background:

  • Allogeneic stem cell transplantation (allo-SCT) is crucial for hematologic malignancies but can lead to cardiac dysfunction and reduced exercise capacity.
  • These complications negatively impact patient quality of life and long-term survival.
  • Preserving cardiorespiratory fitness and cardiac function is vital for improving outcomes after allo-SCT.

Purpose of the Study:

  • To evaluate the efficacy of a multicomponent activity intervention in attenuating reductions in cardiorespiratory fitness and exercise cardiac function in adults undergoing allo-SCT.
  • To assess the impact of the intervention on peak oxygen uptake and exercise cardiac indices.

Main Methods:

  • A randomized controlled trial involving 62 adults scheduled for allo-SCT.
  • Participants were assigned to a 4-month activity program (exercise training and sedentary time reduction) or usual care.
  • Assessments included cardiopulmonary exercise testing, cardiac MRI, echocardiography, and cardiac biomarkers before admission and 12 weeks post-discharge.

Main Results:

  • The activity program attenuated the decline in peak oxygen uptake compared to usual care (interaction P=0.029).
  • Exercise cardiac function, including peak cardiac index and stroke volume index, was preserved in the activity group but declined in the usual care group (interaction P=0.008 and P=0.014, respectively).
  • No significant effects were observed on cardiac biomarkers or echocardiographic indices.

Conclusions:

  • A multicomponent activity program initiated during and continued after allo-SCT is beneficial for preserving cardiorespiratory fitness and exercise cardiac function.
  • These findings suggest potential improvements in cardiovascular morbidity and mortality following allo-SCT.
  • The intervention demonstrates a positive impact on key physiological parameters crucial for recovery and long-term health.