骨髄破壊的同種造血幹細胞移植を受ける患者におけるフレイルと身体活動量の低下および睡眠の質の低下との関連性：Fitbit®パイロットスタディ

Frailty, a multidimensional syndrome of reduced physiologic reserve, is associated with poorer outcomes following allogeneic hematopoietic cell transplantation (alloHCT), even among younger adults. This pilot study explores whether wearable sensor data reflecting physical activity and sleep are associated with pre-transplant frailty status in patients undergoing myeloablative alloHCT.

Adults undergoing first myeloablative alloHCT at the University of Minnesota from June 2022 to January 2023 were enrolled and given Fitbit® Sense devices. Frailty was assessed pre-transplant using Fried Phenotype criteria. Activity and sleep data were collected from hospital admission to day +30 post-transplant. Descriptive and inferential statistics assessed differences across frailty phenotypes.

Nine patients were included: 2 not frail, 5 pre-frail, and 2 frail. Not frail patients demonstrated significantly higher daily steps and active minutes, and lower sedentary time compared to pre-frail and frail groups (all p < 0.01). Frail individuals had significantly reduced deep and REM sleep. The nadir for sleep and peak in sedentary behavior occurred around day +15 post-transplant.

Pre-transplant frailty was associated with decreased physical activity and less restorative sleep during the peri-transplant period. These findings support further study of wearable data to guide personalized supportive care strategies in alloHCT recipients.