Quality of life and peak oxygen uptake are impaired one year after allogeneic hematopoietic stem cell transplantation

Abstract

While life expectancy after allogeneic hematopoietic stem cell transplantation (AHSCT) gradually improves, physical morbidity increases in survivors. Many factors contribute to exercise intolerance and altered physical performance. Cardiopulmonary exercise testing (CPET) is an easy measure of physical function but is rarely performed during follow-up after AHSCT. We conducted a prospective study on 71 patients (25 females; 60±11 years) who underwent AHSCT mainly for acute myeloblastic leukemia (n=28) and lymphoma (n=15). Clinical evaluation, lung function tests and health-related quality of life (HRQoL) evaluation with the 36-item Short Form Health Survey (SF-36) were performed one year after AHSCT. Peak oxygen uptake (VO2) was also assessed in 69 patients who were able to perform CPET. 26 patients (37%) reported disabilities, especially related to fatigue. Importantly, lung function was not significantly altered (FEV 1 104±19% pred.; FVC 108±18% pred.), while 34 patients (48%) displayed peak VO2 150 min/week after hospital discharge had a higher peak VO2 (p=0.028 and 0.008, respectively). Together with a clinical evaluation focusing on fatigue, peak VO2 measurement is of marked interest to identify patients who will require rehabilitation after AHSCT. Pulmonologists should better collaborate with hematologists to assess these patients using CPET one year after AHSCT.