Real-World Outcomes of an Exercise Program Following Hematopoietic Stem Cell Transplantation

Introduction: Exercise is an effective therapy to address physical and psychosocial consequences of hematopoietic stem cell transplantation (HSCT), yet evidence on real-world effectiveness initiated post-HSCT is limited. This study retrospectively evaluated a community-embedded exercise program integrated into routine care at an urban cancer center, with a secondary aim of exploring how baseline physical function influences exercise response. Methods: The Living Well Program is an evidence-based program supervised by Accredited Exercise Physiologists, delivered at Chris O’Brien Lifehouse. HSCT recipients are prescribed individualized, once-weekly 1-h aerobic, resistance, and balance training for 8 wk. Changes in physical function, fatigue, and quality of life from baseline to postintervention were assessed using paired t tests or Wilcoxon signed-rank tests. Hedge’s g indicated the magnitude of the effect. Associations with attendance were examined, and participants were stratified as low- or high-function for each physical function measure. Results: Forty-eight participants (male n = 27, age = 54.3 ± 11.7 yr) were included. Significant improvements occurred across all physical outcome measures ( P ≤ 0.05), with large and moderate effects for 6-min walk distance (g = 0.86, 95% CI: 0.36–1.36) and 30-s sit-to-stand (g = 0.68, 95% CI: 0.05–1.31), respectively, both exceeding minimal clinically important differences. Attendance correlated moderately with leg strength gains ( r = 0.41). Participants with lower baseline 6-min walk distance demonstrated significantly greater gains than those with higher baseline scores ( P < 0.001). Conclusion: Despite variability in data collection inherent to the real-world setting, findings support the clinical effectiveness of an existing exercise program embedded in cancer care. These findings support the value of integrating tailored exercise into post-HSCT care pathways, particularly for those with low physical function who may receive the greatest benefit.