Does rehabilitation pose a risk to patients suffering from haemato‐oncological diseases? Results of a monocentric, retrospective analysis in Germany

Abstract

Objective Patients suffering from haemato‐oncological diseases tend to have a weakened immune system after the end of their therapy. To avoid infections, patients are advised to limit contact with other people. This poses the question whether a stay at a rehabilitation facility can be recommended. Methods We report about 134 rehabilitation stays of patients. Premature discontinuation of the rehabilitation stay was selected as the criterion for a serious complication during the rehabilitation, and the underlying reasons were analysed. Results Compared to the discontinuation rates of patients suffering from solid tumours (2.4%), the percentage of haemato‐oncological patients ending prematurely their rehabilitation stay (8.2%) is significantly increased. This rises to 17.1% for patients who have undergone an allogeneic stem cell transplantation. The analysis of the discontinuation reasons revealed that they were not directly connected to the rehabilitation. Apart from the already known risk factors for premature termination of the rehabilitation stay, we have identified the period (days) between the last therapy and the beginning of the rehabilitation stay as a risk factor. Conclusions We show for the first time that a rehabilitation stay does not pose additional risks for patients suffering from haemato‐oncological diseases.

Impact of SARS-CoV-2 pandemic on rehabilitation of patients after high-dose chemotherapy with allogeneic hematopoietic stem cell transplantation: results of a monocentric, retrospective analysis

“…Platelet levels were also statistically significantly higher in patients during the pandemic. This is interesting, because we had already found a low platelet value as a negative prognostic parameter for a complication during the rehabilitation stay in our publication (Kiefer et al 2020).…”

“…This is especially true for patients after high-dose chemotherapy with allogeneic hematopoietic stem cell transplantation (HDC/alloSCT), who must be assumed to have a particularly weakened immune system (Lum 1987;Park et al 2015;Mehta and Rezvani 2016). However, we were also able to show that the reasons for premature discontinuation of the rehabilitation stay are not related to the rehabilitation, but are due to therapy-or disease-related immunosuppression (Kiefer et al 2020).…”

“…Therefore, even before the global SARS-CoV-2 pandemic, these patients were advised to avoid crowds and to critically consider participation in a rehabilitation stay. In the beginning of 2020, we were able to show that under tightened hygiene conditions, a rehabilitation stay posed no additional risk to patients with hemato-oncologic diseases (Kiefer et al 2020). Among the patients analyzed at that time were 35 patients after HDC/alloSCT.…”

“…The aim is to minimize contact with potentially infectious rehabilitants as much as possible and thus reduces the risk of infection for hemato-oncological patients. The special hygienic conditions for patients after HDC/alloSCT, which were common in our rehabilitation facility before the SARS-CoV-2 pandemic, are described in our previous publication (Kiefer et al 2020). In brief, patients' rooms were cleaned 6 times per week, disinfection of all disinfectable surfaces was carried out six times per week, and bed linen was changed three times per week.…”

“…In 2020, we could show that a rehabilitation stay for patients with hemato-oncological diseases carries an increased risk of being transferred to an acute clinic during the rehabilitation stay due to complications compared to patients with solid tumors. Thus, the most common reason for early termination of a rehabilitation stay was CMV reactivation or fever (Kiefer et al 2020). This is especially true for patients after high-dose chemotherapy with allogeneic hematopoietic stem cell transplantation (HDC/alloSCT), who must be assumed to have a particularly weakened immune system (Lum 1987;Park et al 2015;Mehta and Rezvani 2016).…”