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Open Access 01-05-2019 | Original Article

Factors affecting lower limb muscle strength and cardiopulmonary fitness after allogeneic hematopoietic stem cell transplantation

Authors: Aiko Ishikawa, Yohei Otaka, Michiyo Kamisako, Tetsuya Suzuki, Chieko Miyata, Tetsuya Tsuji, Hideo Matsumoto, Jun Kato, Takehiko Mori, Shinichiro Okamoto, Meigen Liu

Published in: Supportive Care in Cancer | Issue 5/2019

Abstract

Purpose

The aim of this study is to clarify the factors affecting physical function after allogeneic hematopoietic stem cell transplantation (HSCT).

Methods

We retrospectively analyzed 88 patients (median age, 44.5 years) who received allogeneic HSCT. Leg extension torque and peak oxygen consumption (VO₂) were evaluated before and after HSCT. Patient factors (age, sex, underlying diseases, hemoglobin, serum albumin, and Karnofsky performance status score before transplant) and transplant factors (conditioning regimen, days to neutrophil engraftment, grades of acute graft-versus-host disease [GVHD], infections, and the interval between pre- and post-evaluation) were collected via chart review, and were used for correlational and comparison analyses in order to identify the variables associated with reduced post-HSCT leg extension torque and peak VO₂. Stepwise multiple regression analyses for post-HSCT leg extension torque and post-HSCT peak VO₂ were performed using age, sex, and the related variables with a p value < 0.2 in the correlational and comparison analyses.

Results

Leg extension torque and peak VO₂ were significantly reduced after HSCT (p < 0.001). Pre-HSCT leg extension torque, grades of acute GVHD, age, and the interval between pre- and post-evaluation were identified as significant factors associated with reduced post-HSCT leg extension torque. However, none of these factors were significantly associated with reduced post-HSCT peak VO₂, and only its pre-transplant value was identified as a significant factor.

Conclusions

These findings suggest that improvements in muscle strength and cardiopulmonary fitness before HSCT are crucial for maintaining post-treatment physical function, especially in elderly individuals with acute GVHD requiring a long-term stay in a protective environment.

Gruber U, Fegg M, Buchmann M, Kolb HJ, Hiddemann W (2003) The long-term psychosocial effects of haematopoetic stem cell transplantation. Eur J Cancer Care (Engl) 12:249–256. https://doi.org/10.1046/j.1365-2354.2003.00411_2.x CrossRef

Gratwohl A, Baldomero H, Passweg J, Frassoni F, Niederwieser D, Schmitz N, Urbano-Ispizua A; Accreditation Committee of the European Group for Blood and Marrow Transplantation (EBMT); Working Parties Acute (ALWP) Chronic Leukemias (CLWP); Lymphoma Working Party (2003) Hematopoietic stem cell transplantation for hematological malignancies in Europe. Leukemia 17:941–959. https://doi.org/10.1038/sj.leu.2402896 CrossRefPubMed

Kopp M, Holzner B, Meraner V, Sperner-Unterweger B, Kemmler G, Nguyen-Van-Tam DP, Nachbaur D (2005) Quality of life in adult hematopoietic cell transplant patients at least 5 yr after treatment: a comparison with healthy controls. Eur J Haematol 74:304–308. https://doi.org/10.1111/j.1600-0609.2004.00402.x CrossRefPubMed

Hacker ED, Larson J, Kujath A, Peace D, Rondelli D, Gaston L (2011) Strength training following hematopoietic stem cell transplantation. Cancer Nurs 34:238–249. https://doi.org/10.1097/NCC.0b013e3181fb3686 CrossRefPubMedPubMedCentral

Steinberg A, Asher A, Bailey C, Fu JB (2015) The role of physical rehabilitation in stem cell transplantation patients. Support Care Cancer 23:2447–2460. https://doi.org/10.1007/s00520-015-2744-3 CrossRefPubMedPubMedCentral

Larsen J, Nordström G, Ljungman P, Gardulf A (2007) Factors associated with poor general health after stem-cell transplantation. Support Care Cancer 15:849–857. https://doi.org/10.1007/s00520-006-0200-0 CrossRefPubMed

Cunningham BA, Morris G, Cheney CL, Buergel N, Aker SN, Lenssen P (1986) Effects of resistive exercise on skeletal muscle in marrow transplant recipients receiving total parenteral nutrition. JPEN J Parenter Enteral Nutr 10:558–563. https://doi.org/10.1177/0148607186010006558 CrossRefPubMed

Mello M, Tanaka C, Dulley FL (2003) Effects of an exercise program on muscle performance in patients undergoing allogeneic bone marrow transplantation. Bone Marrow Transplant 32:723–728. https://doi.org/10.1038/sj.bmt.1704227 CrossRefPubMed

Jarden M, Baadsgaard MT, Hovgaard DJ, Boesen E, Adamsen L (2009) A randomized trial on the effect of a multimodal intervention on physical capacity, functional performance and quality of life in adult patients undergoing allogeneic SCT. Bone Marrow Transplant 43:725–737. https://doi.org/10.1038/bmt.2009.27 CrossRefPubMed

10.

Baumann FT, Kraut L, Schüle K, Bloch W, Fauser AA (2010) A controlled randomized study examining the effects of exercise therapy on patients undergoing haematopoietic stem cell transplantation. Bone Marrow Transplant 45:355–362. https://doi.org/10.1038/bmt.2009.163 CrossRefPubMed

11.

Baumann FT, Zopf EM, Nykamp E, Kraut L, Schüle K, Elter T, Fauser AA, Bloch W (2011) Physical activity for patients undergoing an allogeneic hematopoietic stem cell transplantation: benefits of a moderate exercise intervention. Eur J Haematol 87:148–156. https://doi.org/10.1111/j.1600-0609.2011.01640.x CrossRefPubMed

12.

Wiskemann J, Dreger P, Schwerdtfeger R, Bondong A, Huber G, Kleindienst N, Ulrich CM, Bohus M (2011) Effects of a partly self-administered exercise program before, during, and after allogeneic stem cell transplantation. Blood 117:2604–2613. https://doi.org/10.1182/blood-2010-09-306308 CrossRefPubMed

13.

DeFor TE, Burns LJ, Gold EM, Weisdorf DJ (2007) A randomized trial of the effect of a walking regimen on the functional status of 100 adult allogeneic donor hematopoietic cell transplant patients. Biol Blood Marrow Transplant 13:948–955. https://doi.org/10.1016/j.bbmt.2007.04.008 CrossRefPubMed

14.

Persoon S, Kersten MJ, van der Weiden K, Buffart LM, Nollet F, Brug J, Chinapaw MJ (2013) Effects of exercise in patients treated with stem cell transplantation for a hematologic malignancy: a systematic review and meta-analysis. Cancer Treat Rev 39:682–690. https://doi.org/10.1016/j.ctrv.2013.01.001 CrossRefPubMed

15.

van Haren IE, Timmerman H, Potting CM, Blijlevens NM, Staal JB, Nijhuis-van der Sanden MW (2013) Physical exercise for patients undergoing hematopoietic stem cell transplantation: systematic review and meta-analyses of randomized controlled trials. Phys Ther 93:514–528. https://doi.org/10.2522/ptj.20120181 CrossRefPubMed

16.

Bergenthal N, Will A, Streckmann F, Wolkewitz KD, Monsef I, Engert A, Elter T, Skoetz N (2014) Aerobic physical exercise for adult patients with haematological malignancies. Cochrane Database Syst Rev 11:CD009075. https://doi.org/10.1002/14651858.CD009075.pub2 CrossRef

17.

Takekiyo T, Dozono K, Mitsuishi T, Murayama Y, Maeda A, Nakano N, Kubota A, Tokunaga M, Takeuchi S, Takatsuka Y, Utsunomiya A (2015) Effect of exercise therapy on muscle mass and physical functioning in patients undergoing allogeneic hematopoietic stem cell transplantation. Support Care Cancer 23:985–992. https://doi.org/10.1007/s00520-014-2425-7 CrossRefPubMed

18.

Morishita S, Kaida K, Yamauchi S, Sota K, Ishii S, Ikegame K, Kodama N, Ogawa H, Domen K (2013) Relationship between corticosteroid dose and declines in physical function among allogeneic hematopoietic stem cell transplantation patients. Support Care Cancer 21:2161–2169. https://doi.org/10.1007/s00520-013-1778-7 CrossRefPubMed

19.

Karvonen MJ, Kentala E, Mustala O (1957) The effects of training on heart rate; a longitudinal study. Ann Med Exp Biol Fenn 35:307–315PubMed

20.

Przepiorka D, Weisdorf D, Martin P, Klingemann HG, Beatty P, Hows J, Thomas ED (1995) 1994 consensus conference on acute GVHD grading. Bone Marrow Transplant 15:825–828PubMed

21.

Tateishi K, Yamada S, Omori Y, Kobayashi T, Aoki H, Morio Y (2001) Reliability of StrengthErgo240 for leg extension strength. Phys Ther Jpn 28:329–331 (in Japanese)

22.

Kobayashi T, Yamada S, Omori Y, Tateishi K, Aoki H, Morio Y (2001) The relationships between muscle strength torque measured by pedaling type isokinetic machine and that by conventional isokinetic dynamometer. Phys Ther Jpn 28:338–342 (in Japanese)

23.

Koike A, Hiroe M, Adachi H, Yajima T, Yamauchi Y, Nogami A, Ito H, Miyahara Y, Korenaga M, Marumo F (1994) Oxygen uptake kinetics are determined by cardiac function at onset of exercise rather than peak exercise in patients with prior myocardial infarction. Circulation 90:2324–2332. https://doi.org/10.1161/01.CIR.90.5.2324 CrossRefPubMed

24.

Shimada Y, Yoshiya I, Hirata T, Takezawa J, Taenaka N (1984) Evaluation of a system for on-line analysis of VO2 and VCO2 for clinical applicability. Anesthesiology 61:311–314CrossRefPubMed

25.

Macfarlane DJ (2001) Automated metabolic gas analysis systems: a review. Sports Med 31:841–861CrossRefPubMed

26.

Vehrs PR, George JD, Fellingham GW, Plowman SA, Dustman-Allen K (2007) Submaximal treadmill exercise test to predict VO₂max in fit adults. Meas Phys Educ Exerc Sci 11:61–72. https://doi.org/10.1080/10913670701294047 CrossRef

27.

Karnofsky DA, Abelmann WH, Craver LF, Burchenal JH (1948) The use of the nitrogen mustards in the palliative treatment of carcinoma. With particular reference to bronchogenic carcinoma. Cancer 1:634–656. https://doi.org/10.1002/1097-0142(194811)1:4<634::AID-CNCR2820010410>3.0.CO;2-L CrossRef

28.

Morishita S, Kaida K, Ikegame K, Yoshihara S, Taniguchi K, Okada M, Kodama N, Ogawa H, Domen K (2012) Impaired physiological function and health-related QOL in patients before hematopoietic stem-cell transplantation. Support Care Cancer 20:821–829. https://doi.org/10.1007/s00520-011-1156-2 CrossRefPubMed

29.

Jones LW, Devlin SM, Maloy MA, Wood WA, Tuohy S, Espiritu N, Aquino J, Kendig T, Michalski MG, Gyurkocza B, Schaffer WL, Ali B, Giralt S, Jakubowski AA (2015) Prognostic importance of pretransplant functional capacity after allogeneic hematopoietic cell transplantation. Oncologist 20:1290–1297. https://doi.org/10.1634/theoncologist.2015-0200 CrossRefPubMedPubMedCentral

30.

Wood WA, Deal AM, Reeve BB, Abernethy AP, Basch E, Mitchell SA, Shatten C, Hie Kim Y, Whitley J, Serody JS, Shea T, Battaglini C (2013) Cardiopulmonary fitness in patients undergoing hematopoietic SCT: a pilot study. Bone Marrow Transplant 48:1342–1349. https://doi.org/10.1038/bmt.2013.58 CrossRefPubMed

31.

Urbain P, Birlinger J, Lambert C, Finke J, Bertz H, Biesalski HK (2013) Longitudinal follow-up of nutritional status and its influencing factors in adults undergoing allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 48:446–451. https://doi.org/10.1038/bmt.2012.158 CrossRefPubMed

32.

Martin PJ, Rizzo JD, Wingard JR, Ballen K, Curtin PT, Cutler C, Litzow MR, Nieto Y, Savani BN, Schriber JR, Shaughnessy PJ, Wall DA, Carpenter PA (2012) First- and second-line systemic treatment of acute graft-versus-host disease: recommendations of the American Society of Blood and Marrow Transplantation. Biol Blood Marrow Transplant 18:1150–1163. https://doi.org/10.1016/j.bbmt.2012.04.005 CrossRefPubMedPubMedCentral

33.

Murata M (2016) Treatment of acute graft-versus-host disease. Rinsho Ketsueki 57:2176–2182 (in Japanese). https://doi.org/10.11406/rinketsu.57.2176 CrossRefPubMed

34.

Ditroilo M, Forte R, Benelli P, Gambarara D, De Vito G (2010) Effects of age and limb dominance on upper and lower limb muscle function in healthy males and females aged 40-80 years. J Sports Sci 28:667–677. https://doi.org/10.1080/02640411003642098 CrossRefPubMed

35.

Hvid L, Aagaard P, Justesen L, Bayer ML, Andersen JL, Ørtenblad N, Kjaer M, Suetta C (2010) Effects of aging on muscle mechanical function and muscle fiber morphology during short-term immobilization and subsequent retraining. J Appl Physiol 109:1628–1634. https://doi.org/10.1152/japplphysiol.00637.2010 CrossRefPubMed

36.

Kubo K, Ishida Y, Komuro T, Tsunoda N, Kanehisa H, Fukunaga T (2007) Age-related differences in the force generation capabilities and tendon extensibilities of knee extensors and plantar flexors in men. J Gerontol A Biol Sci Med Sci 62:1252–1258CrossRefPubMed

37.

Macaluso A, Nimmo MA, Foster JE, Cockburn M, McMillan NC, De Vito G (2002) Contractile muscle volume and agonist-antagonist coactivation account for differences in torque between young and older women. Muscle Nerve 25:858–863. https://doi.org/10.1002/mus.10113 CrossRefPubMed

38.

Gledhill N (1982) Blood doping and related issues: a brief review. Med Sci Sports Exerc 14:183–189CrossRefPubMed

39.

Gledhill N, Warburton D, Jamnik V (1999) Haemoglobin, blood volume, cardiac function, and aerobic power. Can J Appl Physiol 24:54–65CrossRefPubMed

40.

Benedetto D, Rao CM, Cefalù C, Aguglia DO, Cattadori G, D'Ascola DG, Benedetto FA, Agostoni P, Sciomer S (2015) Effects of blood transfusion on exercise capacity in thalassemia major patients. PLoS One 10:e0127553. https://doi.org/10.1371/journal.pone.0127553 CrossRefPubMedPubMedCentral

41.

Cattadori G, Agostoni P, Corrà U, Sinagra G, Veglia F, Salvioni E, Bonomi A, La Gioia R, Scardovi AB, Ferraironi A, Emdin M, Metra M, Di Lenarda A, Limongelli G, Raimondo R, Re F, Guazzi M, Belardinelli R, Parati G, Caravita S, Magrì D, Lombardi C, Frigerio M, Oliva F, Girola D, Mezzani A, Farina S, Mapelli M, Scrutinio D, Pacileo G, Apostolo A, Iorio A, Paolillo S, Filardi PP, Gargiulo P, Bussotti M, Marchese G, Correale M, Badagliacca R, Sciomer S, Palermo P, Contini M, Giannuzzi P, Battaia E, Cicoira M, Clemenza F, Minà C, Binno S, Passino C, Piepoli M, MECKI score Research Group (appendix) (2017) Heart failure and anemia: effects on prognostic variables. Eur J Intern Med 37:56–63. https://doi.org/10.1016/j.ejim.2016.09.011 CrossRefPubMed

42.

Odden M, Whooley M, Shlipak M (2004) Association of chronic kidney disease and anemia with physical capacity: the heart and soul study. J Am Soc Nephrol 15:2908–2915. https://doi.org/10.1097/01.ASN.0000143743.78092.E3 CrossRefPubMed

43.

Ferrari M, Manea L, Anton K, Bruzzone P, Meneghello M, Zamboni F, Purgato L, Cazzoletti L, Ferrari P, Testi R (2015) Anemia and hemoglobin serum levels are associated with exercise capacity and quality of life in chronic obstructive pulmonary disease. BMC Pulm Med 15:58. https://doi.org/10.1186/s12890-015-0050-y CrossRefPubMedPubMedCentral

44.

van Haren I, Staal JB, Potting CM, Atsma F, Hoogeboom TJ, Blijlevens NMA, Nijhuis-van der Sanden MWG (2018) Physical exercise prior to hematopoietic stem cell transplantation: a feasibility study. Physiother Theory Pract 34(10):747–756. https://doi.org/10.1080/09593985.2018.1423655 CrossRefPubMed

Title: Factors affecting lower limb muscle strength and cardiopulmonary fitness after allogeneic hematopoietic stem cell transplantation
Authors: Aiko Ishikawa
Yohei Otaka
Michiyo Kamisako
Tetsuya Suzuki
Chieko Miyata
Tetsuya Tsuji
Hideo Matsumoto
Jun Kato
Takehiko Mori
Shinichiro Okamoto
Meigen Liu
Publication date: 01-05-2019
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 5/2019
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-018-4433-5

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