Effects of various physical activities of patients upon the outcomes of hematopoietic stem cell transplantation
Allogeneic stem cell transplantation (allo-HCT) is an effective curative treatment for patients with haematological malignancies in high-risk diseases e.g. acute leukaemia. However, patients suffer from numerous treatment related side-effects and complications, and the transplant-related mortality is high. Exercise is a promising intervention approach for this group of patients. Over the last years, several clinical trials have contributed to the growing body of evidence showing the beneficial effects of exercise in cancer patients. The purpose of our study was to evaluate the effect of various types of physical activity on the recovery of hemopoiesis after BMT.
Materials and methods
We examined 11 patients for 3 months in the period of BMT (20-56 years) with haematological diseases undergoing allogeneic stem cell transplantion, of these, 8 patients (66%) were diagnosed with acute leukemia. 6 patients had a non-myeloablative conditioning regimen, and 5 had a myeloablative regimen. Criteria for patients included in this sample were: no symptoms of coronary illness or uncontrolled high blood pressure, being over 18 years of age. For all patients, this was the first transplantation. The source of the transplant in 2 patients is BM, in 9 patients the PBSC. We determined physical endurance with a 6-minute walk test, and muscular strength with a dynamometer. These tests were performed before transplantation and immediately after the signs of transplant engraftment. All 11 patients received various physical loads throughout the time until the recovery of hemopoiesis, even in the period of deep cytopenia. Two patients had an aerobic exercise (an exercise bike), from 5 to 15 minutes, depending on the state of health and the results of blood tests. 9 patients performed physical exercises in the initial sitting or lying position, depending on the state of health and the results of blood tests.
All patients underwent a course of physical therapy. No patient quit training. Engraftment of the graft was recorded in all patients during normal periods (from D + 17 to D + 31). Only 2 patients (16%) required the use of CSF. A 6-minute test, performed after engraftment of the transplant, showed different results: in 6 patients the results of this test were observed – an increase in the distance traveled. Only in 3 patients muscular strength increased by the results of dynamometry.
All patients reported improvement in mood after physical activity.
Physical exercise is feasible in patients with pancytopenia after allo-HCT. Further controlled studies are required to evaluate if physical activity improves the outcomes of transplantation.
Allogeneic stem cell transplantation, cytopenia, 6-minute walk test, dynamometry, physical exercise.