Influencing factors of cardiorespiratory fitness in allogeneic stem cell transplant candidates prior to transplantation

Abstract

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. VO2peak was significantly reduced compared with reference data. In total, VO2peak 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%). VO2peak 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.

Health‐related quality of life and physical functioning in patients participating in a rehabilitation programme, undergoing non‐myeloablative allogeneic haematopoietic stem cell transplantation: Outcomes from a single arm longitudinal study

“…(Limbach et al, 2021). In line with our findings, the VO 2peak values compared to a healthy reference group were significantly reduced in this study as well (Limbach et al, 2021). There is emerging evidence that very low cardiorespiratory fitness may predict mortality in haematological patients undergoing HSCT (Kelsey et al, 2014;Wood et al, 2013).…”

“…Yet the large range in individual changes of cardiorespiratory fitness at 12-month followup, compared with baseline, might reflect the different time points where patients face complications, like infections or GVHD (Bishop, 2009;Mosher et al, 2009). (Limbach et al, 2021). In line with our findings, the VO 2peak values compared to a healthy reference group were significantly reduced in this study as well (Limbach et al, 2021).…”

Rehabilitation Needs for Patients Undergoing CAR T-Cell Therapy

“…[ 37 ] Limbach et al found that older female patients with low physical activity and who received cardiotoxic therapy prior to allogeneic HSCT are at risk of decreased cardiorespiratory function. [ 38 ] Also, higher BMI and lower physical activity were significant predictors for low cardiorespiratory fitness. As seen in our case, the patient had a decline in distance by 44 m and required a RW.…”

Cardiopulmonary performance in allogeneic hematopoietic cell transplantation recipients—evaluation of pre-transplant risk assessments

“…Patients had to perform until exhaustion starting at 20 W with a 10-W increase every minute. Exhaustion was determined by respiratory exchange ratio (RER) ≥ 1.1 or a heart rate ≥85% of the age predicted maximum [26,27]. The RER describes the ratio of carbon dioxide produced and oxygen consumed.…”