Why the study?
Cardiorespiratory fitness appears prognostic prior to allogeneic stem cell transplantation, but factors influencing fitness in these candidates had not been studied.
Cardiorespiratory fitness is significantly reduced in allogeneic stem cell transplant candidates and is negatively impacted by high BMI, low physical activity, prior cardiotoxic therapies, and low hemoglobin levels.
CRF predictors identified via regression may guide pre-transplant counseling; leaves open validation and intervention targets in larger cohorts.
Purpose Cardiorespiratory fitness (CRF) seems to be prognostic prior to allogeneic stem cell transplantation (allo-HSCT). Influencing factors of CRF in allo-HSCT candidates have not been studied so far. Aim was to identify potentially influencing factors on CRF. Methods To assess CRF, a maximal cardiopulmonary exercise test (CPET) was performed on average 2.6 ± 7.2 days prior to admission. A regression analysis was conducted, with the following predictors: gender, age, body mass index (BMI), time between last therapy and allo-HSCT (t_Therapies), number of cardiotoxic therapies (n_Cardiotox), number of transplantations (n_Transplantations), comorbidity index (HCT-CI), hemoglobin level of the last 3 months (area under the curve), and physical activity. Results A total of 194 patients performed a CPET. VO 2peak was significantly reduced compared with reference data. In total, VO 2peak was 21.4 ml/min/kg (− 27.5%, p < 0.05). Men showed a significant larger percentage difference from reference value (− 29.1%, p < 0.05) than women (− 24.4%). VO 2peak was significantly ( p < 0.05) influenced by age (β = − 0.11), female gender (β = − 3.01), BMI (β = − 0.44), n_Cardiotox (β = − 0.73), hemoglobin level (β = 0.56), and physical activity prior to diagnosis (β = 0.10). Conclusions Our study demonstrates a decreased CRF indicating the potential need of prehabilitative exercise. We revealed some influencing factors on CRF. Those patients could benefit the most from exercise.
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Limbach et al. (2020) studied this question.
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