What question did this study set out to answer?

This research aims to identify baseline predictors of quality of life following autologous hematopoietic stem cell transplantation.

June 5, 2026Open Access

Baseline Functional Performance Predicts Better Long-Term Self-Reported Physical Function After Auto-HSCT

Key Points

This research aims to identify baseline predictors of quality of life following autologous hematopoietic stem cell transplantation.
Assessments were conducted on physical function, body composition, and quality of life in U.S. veterans (N = 23) before and one month after Auto-HSCT.
Quality of life and survival data collected every six months for two years post-HSCT.
Statistical analyses included Generalized Estimating Equation regression and Spearman’s correlations to evaluate relationships between baseline variables and quality of life outcomes.
Depression and anxiety levels improved significantly one month after Auto-HSCT (p ≤ 0.039), while fatigue worsened (p ≤ 0.024) up to five months post-HSCT.
Bone-Marrow-Transplant-related quality of life improved significantly at five months (p = 0.014), while self-reported function improved one to two years post-HSCT (p ≤ 0.021).
Greater performance on the 30 s chair stand test correlated with better self-reported function (r = 0.76–0.91, p ≤ 0.007) and on the 6 min walk test with reduced symptom burden (r = 0.71–0.81, p ≤ 0.01) during follow-up.

Abstract

Background/Objectives: Determination of baseline predictors of longer-term quality of life (QOL) after autologous hematopoietic stem cell transplantation (Auto-HSCT) may identify patients with the greatest supportive care needs. We hypothesized that baseline older age, weight loss, and worse functional performance would negatively predict QOL over two years post-HSCT. Methods: Physical function, body composition, and QOL were assessed before (PRE) and one month (1MO) after Auto-HSCT in U.S. Veterans (N = 23). QOL and survival were also assessed approximately every six months for two years after Auto-HSCT (5MO, 1YR, 1.5YR, and 2YR). Changes over time were tested via Generalized Estimating Equation regression analyses (p < 0.05 = significant). The impact of PRE variables on QOL at each follow-up was tested via Spearman’s correlations (p < 0.01 = significant). Results: Relative to PRE, depression and anxiety significantly improved (p ≤ 0.039) at 1MO while fatigue and vitality significantly worsened (p ≤ 0.024) 1MO to 5MO post-HSCT. Vitality, depression, and anxiety returned to PRE levels thereafter, while fatigue trajectory varied depending on the survey used. Bone-Marrow-Transplant-related QOL significantly improved at 5MO (p = 0.014) while self-reported function (p ≤ 0.021) and physical activity (p ≤ 0.045) significantly improved 1-2YR post-HSCT. Greater PRE 30 s chair stand test performance consistently correlated with better self-reported function 1-2YR (r = 0.76–0.91, p ≤ 0.007) post-HSCT. Greater PRE 6 min walk test performance consistently correlated with better symptom burden 1-2YR (r = 0.71–0.81, p ≤ 0.01) post-HSCT. Conclusions: In support of our hypothesis, baseline functional performance was associated with QOL during two years of recovery after Auto-HSCT; older age and recent weight loss at baseline only predicted worse baseline QOL. Our data indicates that evaluation of the 30 s chair stand and 6 min walk tests as rehabilitation targets and/or predictors of QOL, fitness, or mortality after Auto-HSCT are warranted. Larger, controlled studies are needed to confirm the findings from this exploratory analysis.

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