Ole Henrik Myrdal1,2, Phoi Phoi Diep3,4,5, Ellen Ruud3,4, Lorentz Brinch6, Richard John Massey3,7, Elisabeth Edvardsen8,9, Johny Kongerud10,3, May B Lund10,3, Liv Ingunn Sikkeland10,3. 1. Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet, Box 4950 Nydalen, 0424, Oslo, Norway. omyrda@ous-hf.no. 2. Institute of Clinical Medicine, University of Oslo, Oslo, Norway. omyrda@ous-hf.no. 3. Institute of Clinical Medicine, University of Oslo, Oslo, Norway. 4. Department of Pediatric Oncology and Haematology, Oslo University Hospital, Rikshospitalet, Oslo, Norway. 5. Department of Pediatric Research, Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway. 6. Department of Haematology, Oslo University Hospital, Rikshospitalet, Oslo, Norway. 7. Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway. 8. Department of Physical Performance, The Norwegian School of Sport Sciences, Oslo, Norway. 9. Department of Pulmonary Medicine, Oslo University Hospital Ullevål, Oslo, Norway. 10. Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet, Box 4950 Nydalen, 0424, Oslo, Norway.
Abstract
PURPOSE: Survivors of allogeneic hematopoietic stem cell transplantation (allo-HSCT) are at risk for cardiopulmonary adverse events. Data on long-term effects on cardiorespiratory fitness are limited. To address the gap in knowledge, we aimed to determine peak oxygen uptake (V̇O2peak) and identify associations between cardiorespiratory fitness and clinical characteristics, self-reported physical activity, cardiac, and pulmonary function. METHODS: In a nationwide, single-center cross-sectional study, 90 survivors [aged median (range) 35 (17-54) years, 56% females] were examined, 17 (6-26) years after allo-HSCT. Myeloablative conditioning comprised busulfan/cyclophosphamide or cyclophosphamide only. Methods included pulmonary function tests, echocardiography, and cardiopulmonary exercise test. RESULTS: Chronic graft-versus-host disease (cGVHD) was found in 31% of the subjects, of whom 40% had bronchiolitis obliterans syndrome (BOS). Seventy-one percent of the survivors did not meet WHO recommendations for physical activity and 42% were overweight. Reduced gas diffusion (DLCO) and systolic ventricular dysfunction (LVEF) were found in 44% and 31%, respectively. For the group, mean (95% CI), V̇O2peak was 36.4 (34.7-38.0) mL/min/kg [89 (85-93)% of predicted]. V̇O2peak was low at 43%. Cardiopulmonary factors and deconditioning were equally common limitations for exercise. In a multiple linear regression model, low V̇O2peak was associated with low DLCO, low LVEF, BOS, overweight, and inactivity. CONCLUSION: Half of the survivors had reduced cardiorespiratory fitness median 17 years after allo-HSCT. Cardiopulmonary factors and deconditioning were equally common limitations to exercise. We encourage long-term cardiopulmonary monitoring of allo-HSCT survivors and targeted advice on modifiable lifestyle factors.
PURPOSE: Survivors of allogeneic hematopoietic stem cell transplantation (allo-HSCT) are at risk for cardiopulmonary adverse events. Data on long-term effects on cardiorespiratory fitness are limited. To address the gap in knowledge, we aimed to determine peak oxygen uptake (V̇O2peak) and identify associations between cardiorespiratory fitness and clinical characteristics, self-reported physical activity, cardiac, and pulmonary function. METHODS: In a nationwide, single-center cross-sectional study, 90 survivors [aged median (range) 35 (17-54) years, 56% females] were examined, 17 (6-26) years after allo-HSCT. Myeloablative conditioning comprised busulfan/cyclophosphamide or cyclophosphamide only. Methods included pulmonary function tests, echocardiography, and cardiopulmonary exercise test. RESULTS: Chronic graft-versus-host disease (cGVHD) was found in 31% of the subjects, of whom 40% had bronchiolitis obliterans syndrome (BOS). Seventy-one percent of the survivors did not meet WHO recommendations for physical activity and 42% were overweight. Reduced gas diffusion (DLCO) and systolic ventricular dysfunction (LVEF) were found in 44% and 31%, respectively. For the group, mean (95% CI), V̇O2peak was 36.4 (34.7-38.0) mL/min/kg [89 (85-93)% of predicted]. V̇O2peak was low at 43%. Cardiopulmonary factors and deconditioning were equally common limitations for exercise. In a multiple linear regression model, low V̇O2peak was associated with low DLCO, low LVEF, BOS, overweight, and inactivity. CONCLUSION: Half of the survivors had reduced cardiorespiratory fitness median 17 years after allo-HSCT. Cardiopulmonary factors and deconditioning were equally common limitations to exercise. We encourage long-term cardiopulmonary monitoring of allo-HSCT survivors and targeted advice on modifiable lifestyle factors.
Authors: Ole Henrik Myrdal; Trond Mogens Aaløkken; Phoi Phoi Diep; Ellen Ruud; Lorentz Brinch; Kristian Fosså; Henrik Mangseth; Johny Kongerud; Liv Ingunn Sikkeland; May B Lund Journal: Respiration Date: 2021-12-22 Impact factor: 3.966
Authors: Kristine Eidal Tanem; Petter Wilberg; Phoi Phoi Diep; Ellen Ruud; Anne B Skaare; Lorentz Brinch; Bente Brokstad Herlofson Journal: Support Care Cancer Date: 2022-01-24 Impact factor: 3.603