Analysis of Prognostic Impacts of The Rehabilitation Pre- and Post Allogeneic Hematopoietic Stem Cell Transplantation Higher Tolerability Can Predict Social Reintegration
【Supercategory：7. DESCENTE SPORTS SCIENCE Subcategory：7.42 Vol.42】
ABSTRACT
Allogeneic hematopoietic stem cell transplantation（ bone marrow transplantation） is a curative treatment for refractory hematopoietic tumors such as leukemia and lymphoma. Various complications are known in transplantation because many drugs are used over a long period of time and the immune system remains weakened. These acute and chronic complications tend to reduce quality of life because they force behavioral restrictions. The importance of rehabilitation based on exercise therapy has been suggested in order to reduce complications after transplantation and improve the quality of life. However, the impact of aggressive rehabilitation on post-transplant vital prognosis and quality of life remains unproven. In this research project, detailed data on prognosis, complications, and quality of life are combined with a database on rehabilitation. Once proven effective, the goal is to popularize rehabilitation in transplant treatment and incorporate it into standard care.This retrospective cohort study aims to illustrate the precise epidemiology of social reintegration later after allo-HSCT and determine its predictive indicators. We enrolled 56 patients, and social reintegration was attained in 40 patients （71%） at 2 years post-HSCT. Reintegration failure markedly correlated with inferior performance status and concurrent chronic graft-versus-host disease. In non-reintegrated patients, the physical function at discharge measured by the 6-min walking distance（ 6MWD） was markedly decreased. In the multivariate risk analyses, sex （female; odds ratio （OR） 0.07; 95% confidence interval（ CI） : 0.01?0.54; p=0.01） , HCT-CI（ ?2; OR 0.10; 95%CI: 0.01?0.84; p=0.03） , and change in 6MWD （per 5% increase; OR 1.47; 95%CI: 1.01?2.13; p=0.04） were significant predictors of later social reintegration. This study suggests that a multidisciplinary strategy including rehabilitation is essential, especially for patients with poor predictive markers at an early phase, and suitable rehabilitation programs to prevent a decline in exercise tolerance should be considered to improve social reintegration and overall QOL in patients after allo-HSCT.
DECENTE SPORTS SCIENCE Vol.42/The DESCENTE AND ISHIMOTO MEMORIAL FOUNDATION FOR THE PROMOTION SPORTS SCIENCE
Allogeneic hematopoietic stem cell transplantation（ bone marrow transplantation） is a curative treatment for refractory hematopoietic tumors such as leukemia and lymphoma. Various complications are known in transplantation because many drugs are used over a long period of time and the immune system remains weakened. These acute and chronic complications tend to reduce quality of life because they force behavioral restrictions. The importance of rehabilitation based on exercise therapy has been suggested in order to reduce complications after transplantation and improve the quality of life. However, the impact of aggressive rehabilitation on post-transplant vital prognosis and quality of life remains unproven. In this research project, detailed data on prognosis, complications, and quality of life are combined with a database on rehabilitation. Once proven effective, the goal is to popularize rehabilitation in transplant treatment and incorporate it into standard care.This retrospective cohort study aims to illustrate the precise epidemiology of social reintegration later after allo-HSCT and determine its predictive indicators. We enrolled 56 patients, and social reintegration was attained in 40 patients （71%） at 2 years post-HSCT. Reintegration failure markedly correlated with inferior performance status and concurrent chronic graft-versus-host disease. In non-reintegrated patients, the physical function at discharge measured by the 6-min walking distance（ 6MWD） was markedly decreased. In the multivariate risk analyses, sex （female; odds ratio （OR） 0.07; 95% confidence interval（ CI） : 0.01?0.54; p=0.01） , HCT-CI（ ?2; OR 0.10; 95%CI: 0.01?0.84; p=0.03） , and change in 6MWD （per 5% increase; OR 1.47; 95%CI: 1.01?2.13; p=0.04） were significant predictors of later social reintegration. This study suggests that a multidisciplinary strategy including rehabilitation is essential, especially for patients with poor predictive markers at an early phase, and suitable rehabilitation programs to prevent a decline in exercise tolerance should be considered to improve social reintegration and overall QOL in patients after allo-HSCT.
DECENTE SPORTS SCIENCE Vol.42/The DESCENTE AND ISHIMOTO MEMORIAL FOUNDATION FOR THE PROMOTION SPORTS SCIENCE
| Researcher | Yasuyuki Arai, Ryota Hamada |
|---|---|
| University or institution | Kyoto University Hospital |
Keywords
rehabilitation, social reintegration, 6-min walking distance, stem cell transplantation, clinical tria