Tatsushi Wakasugi1, Shinichiro Morishita2,3, Katsuji Kaida4, Kazuhiro Ikegame4, Yuki Uchiyama3, Kazuhisa Domen3. 1. Department of Rehabilitation, Hyogo College of Medicine College Hospital, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan. waka.t2s920@gmail.com. 2. Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan. 3. Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. 4. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
Abstract
PURPOSE: This study aimed to investigate the relationship between exercise intolerance, muscle oxidative metabolism, and cardiopulmonary function following allogeneic hematopoietic stem cell transplantation (allo-HSCT) in a sterile isolation room setting. METHODS: This was a prospective observational cohort study conducted in a single center. Fourteen patients with hematopoietic malignancies who had undergone allo-HSCT were included in this study from June 2015 to April 2020. Patients received donor HSCT after high dose-chemotherapy and total-body irradiation. Physical activity was limited during treatments. Outcome measures included body anthropometric measurements, exercise tolerance tests using the ramp protocol, pulmonary function tests, and near-infrared spectroscopy (NIRS) measurements. Data of pre- and posttransplant measurements were compared using the paired t test or nonparametric Wilcoxon U test. Associations were assessed using the Pearson or nonparametric Spearman correlations. RESULTS: NIRS showed reduced muscle consumption and extraction of oxygen in the posttransplant period compared to the pretransplant period (ΔStO2 min pre: -18.6% vs. post: -13.0%, P = 0.04; ΔHHb max pre: 4.21μmol/l vs. post: 3.31μmol/l: P = 0.048). Exercise tolerance had reduced following allo-HSCT (Peak workload pre: 70.3 W vs. post: 58.0 W: P = 0.014). Furthermore, exercise intolerance was associated with pulmonary function, muscle oxygen consumption, and muscle oxygen extraction (all P <0.05). CONCLUSION: This analysis revealed that exercise intolerance following allo-HSCT was associated with pulmonary dysfunction and muscle oxidative dysfunction. These findings could help identify the physical function associated with impaired tissue oxygen transport leading to exercise intolerance following allo-HSCT.
PURPOSE: This study aimed to investigate the relationship between exercise intolerance, muscle oxidative metabolism, and cardiopulmonary function following allogeneic hematopoietic stem cell transplantation (allo-HSCT) in a sterile isolation room setting. METHODS: This was a prospective observational cohort study conducted in a single center. Fourteen patients with hematopoietic malignancies who had undergone allo-HSCT were included in this study from June 2015 to April 2020. Patients received donor HSCT after high dose-chemotherapy and total-body irradiation. Physical activity was limited during treatments. Outcome measures included body anthropometric measurements, exercise tolerance tests using the ramp protocol, pulmonary function tests, and near-infrared spectroscopy (NIRS) measurements. Data of pre- and posttransplant measurements were compared using the paired t test or nonparametric Wilcoxon U test. Associations were assessed using the Pearson or nonparametric Spearman correlations. RESULTS: NIRS showed reduced muscle consumption and extraction of oxygen in the posttransplant period compared to the pretransplant period (ΔStO2 min pre: -18.6% vs. post: -13.0%, P = 0.04; ΔHHb max pre: 4.21μmol/l vs. post: 3.31μmol/l: P = 0.048). Exercise tolerance had reduced following allo-HSCT (Peak workload pre: 70.3 W vs. post: 58.0 W: P = 0.014). Furthermore, exercise intolerance was associated with pulmonary function, muscle oxygen consumption, and muscle oxygen extraction (all P <0.05). CONCLUSION: This analysis revealed that exercise intolerance following allo-HSCT was associated with pulmonary dysfunction and muscle oxidative dysfunction. These findings could help identify the physical function associated with impaired tissue oxygen transport leading to exercise intolerance following allo-HSCT.
Authors: Brian L Graham; Irene Steenbruggen; Martin R Miller; Igor Z Barjaktarevic; Brendan G Cooper; Graham L Hall; Teal S Hallstrand; David A Kaminsky; Kevin McCarthy; Meredith C McCormack; Cristine E Oropez; Margaret Rosenfeld; Sanja Stanojevic; Maureen P Swanney; Bruce R Thompson Journal: Am J Respir Crit Care Med Date: 2019-10-15 Impact factor: 21.405
Authors: Hayley T Dillon; Nicholas J Saner; Tegan Ilsley; David Kliman; Andrew Spencer; Sharon Avery; David W Dunstan; Robin M Daly; Steve F Fraser; Neville Owen; Brigid M Lynch; Bronwyn A Kingwell; Andre La Gerche; Erin J Howden Journal: BMC Cancer Date: 2022-08-17 Impact factor: 4.638