Impact of Physical Conditioning on Outcomes in Transplant Patients: Retrospective Data Analysis

Abstract

Background Stem cell transplantation is a potential curative procedure for many patients with hematologic malignancies. These patients because of age, co-morbid medical conditions and prior therapies can present in various physical conditions from good performance status to poor or frail. This may affect transplant outcome in terms of survival and relapse free survival. A component of our transplant program is a pre-transplant evaluation with cancer rehab specialists. Standard measures are obtained including the visual analog scales for pain and fatigue, timed up and go, and distress thermometer. An exercise program is prescribed for the patient prior to admission as well as during hospitalization and discharge. At day 60 after transplant these standard measures are re-assessed. Our study aims to assess the relationship of measurable physical conditioning metrics and outcomes in survival, progression free survival, relapse rate and transplant related mortality. Methods We conducted a retrospective review of 134 patients who have undergone hematopoietic stem cell transplantation with at least 60 days of follow-up. We collected the data from their pre-transplant cancer rehab evaluation and their 60 day post transplant evaluation including their Karnofsky Performance Status (KPS) score, timed up and go, fatigue and distress measurements. Using their KPS score patients were categorized as high performers (KPS >80) and low performers (KPS Results Our data showed there was increased survival of high performers compared to low performers (p=0.0270). Patients experienced significant decreases in pain scores, fatigue, and distress after transplant. There were no significant differences in progression free survival, relapse rate, or transplant related mortality between high performers and low performers. Conclusions Physical conditioning can lead to better outcomes in terms of survival and symptoms; fatigue, pain, and distress. Future studies of rehab interventions are needed to better understand our observed survival and symptom benefit.