Assessment of the physical fitness status of patients with hematological malignancies qualified for hematopoietic stem cell transplantation.

Abstract

Background: Hematopoietic stem cell transplantation (HSCT) is a procedure commonly used in the treatment of various hematological disorders with the aim of curing the patient or prolonging life. The vast majority of patients must have antineoplastic therapy before HSCT, which can result in weight loss, sarcopenia or cachexia. Additionally, there is a high risk of malnutrition and physical deterioration during HSCT. By assessing physical fitness prior to HSCT, a physical therapist can individualize an exercise program, which in turn may speed up recovery after HSCT.

Objectives: The aim of the study was to assess the physical fitness of patients with hematological malignancies qualified for HSCT as an indication for prehabilitation.

Material and methods: The study included 65 patients with hematological malignancies who were qualified for HSCT between September 1, 2022, and September 1, 2023. The reference group consisted of 219 healthy adults. The clinical study protocol involved participants performing 3 tests: the 6-minute walk test (6MWT), the timed-up and go test (TUG) and the 30-second chair-stand test (30CST).

Results: Patients with hematological malignancies were characterized by significantly lower endurance capacity (median (Me) = 420.50 (IQR 110.25) vs Me = 580.00 (IQR 133.00); p < 0.001) and significantly lower body strength (Me = 11.00 (IQR 6.00) vs Me = 15.00 (IQR 5.00); p < 0.001). There was also a statistically significant difference in the diagnosis and in the number of lines of systemic therapy. Additionally, a statistically significant difference was observed between the outcomes of the physical fitness level, particularly for TUG and 30CST, and the time from diagnosis to transplantation.

Conclusions: The presented results suggest a negative consequence of hematological disease and its treatment on the functional status of patients qualified for HSCT and indicate the need for individualized rehabilitation management depending on the type of diagnosis, the number of lines of systemic therapy, and the time between diagnosis and transplantation.