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Supportive Care in Cancer

, Volume 20, Issue 4, pp 821–829 | Cite as

Impaired physiological function and health-related QOL in patients before hematopoietic stem-cell transplantation

  • Shinichiro Morishita
  • Katsuji Kaida
  • Kazuhiro Ikegame
  • Satoshi Yoshihara
  • Kyoko Taniguchi
  • Masaya Okada
  • Norihiko Kodama
  • Hiroyasu Ogawa
  • Kazuhisa Domen
Original Article

Abstract

Purpose

Patients' physiological functions and health-related quality of life (QOL) are useful for planning physical therapy after allogeneic hematopoietic stem-cell transplantation (allo-HSCT), but have not been extensively examined prior to transplantation. We investigated whether physiological functions and health-related QOL were reduced in patients before undergoing allo-HSCT.

Methods

All patients (n = 110) who underwent allo-HSCT between May 2007 and April 2010 at Hyogo College of Medicine Hospital were included in this study and evaluated for hand-grip and knee-extensor strength; 6-min walk test (6MWT) and health-related QOL (SF-36) were also used for evaluation.

Results

Grip strength, knee-extensor strength, 6MWT, and all eight SF-36 health-related QOL subscale scores significantly decreased in HSCT patients compared to population norms (all, P < 0.01). Health-related QOL is associated with various confounding factors such as fatigue and sex. Loss of physiological function is also associated with confounding factors; one such association was found between skeletal muscle strength and previous HSCT treatment.

Conclusion

Health-related QOL and loss of physiological function have a variety confounding factors. Patients scheduled for HSCT may have physiological weaknesses prior to transplant, which need to be considered when planning an exercise regimen during and after transplantation.

Keywords

Hematopoietic stem-cell transplantation Muscle strength 6-min walk test Quality of life 

Notes

Acknowledgments

The authors are grateful to the study participants, the physiotherapists at the Rehabilitation Department, and the physicians at the Division of Hematology in Hyogo College of Medicine Hospital.

Conflict of interest

The authors declare no conflict of interest.

References

  1. 1.
    Schmit-Pokorny K (2009) Expanding indications for stem cell transplantation. Semin Oncol Nurs 25:105–114PubMedCrossRefGoogle Scholar
  2. 2.
    Parmar S, de Lima M (2010) Hematopoietic stem cell transplantation for myelodysplastic syndrome. Biol Blood Marrow Transplant 16(1 Suppl):S37–S44PubMedCrossRefGoogle Scholar
  3. 3.
    Hamadani M, Awan FT, Copelan EA (2008) Hematopoietic stem cell transplantation in adults with acute myeloid leukemia. Biol Blood Marrow Transplant 14:556–567PubMedCrossRefGoogle Scholar
  4. 4.
    Gillis T, Donovan E (2001) Rehabilitation following bone marrow transplantation. Cancer 92(4 Suppl):998–1007PubMedCrossRefGoogle Scholar
  5. 5.
    Kovalszki A, Schumaker GL, Klein A, Terrin N, White AC (2008) Reduced respiratory and skeletal muscle strength in survivors of sibling or unrelated donor hematopoietic stem cell transplantation. Bone Marrow Transplant 41:965–969PubMedCrossRefGoogle Scholar
  6. 6.
    Wiskemann J, Huber G (2008) Physical exercise as adjuvant therapy for patients undergoing hematopoietic stem cell transplantation. Bone Marrow Transplant 41:321–329PubMedCrossRefGoogle Scholar
  7. 7.
    Hayes S, Davies P, Parker T, Bashford J, Green A (2004) Role of a mixed type, moderate intensity exercise programme after peripheral blood stem cell transplantation. Br J Sports Med 38:304–309PubMedCrossRefGoogle Scholar
  8. 8.
    Mello M, Tanaka C, Dulley F (2003) Effects of an exercise program on muscle performance in patients undergoing allogeneic bone marrow transplantation. Bone Marrow Transplant 32:723–728PubMedCrossRefGoogle Scholar
  9. 9.
    Baumann F, Kraut L, Schüle K, Bloch W, Fauser A (2010) A controlled randomized study examining the effects of exercise therapy on patients undergoing haematopoietic stem cell transplantation. Bone Marrow Transplant 45:355–362PubMedCrossRefGoogle Scholar
  10. 10.
    Jarden M, Hovgaard D, Boesen E, Quist M, Adamsen L (2007) Pilot study of a multimodal intervention: mixed-type exercise and psychoeducation in patients undergoing allogeneic stem cell transplantation. Bone Marrow Transplant 40:793–800PubMedCrossRefGoogle Scholar
  11. 11.
    Jarden M, Baadsgaard M, Hovgaard D, 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 43:725–737PubMedCrossRefGoogle Scholar
  12. 12.
    Hayes S, Davies P, Parker T, Bashford J, Newman B (2004) Quality of life changes following peripheral blood stem cell transplantation and participation in a mixed-type, moderate-intensity, exercise program. Bone Marrow Transplant 33:553–558PubMedCrossRefGoogle Scholar
  13. 13.
    Courneya K, Keats M, Turner A (2009) Physical exercise and quality of life in cancer patients following high dose chemotherapy and autologous bone marrow transplantation. Psychooncology 9:127–136Google Scholar
  14. 14.
    White A, Terrin N, Miller K, Ryan H (2005) Impaired respiratory and skeletal muscle strength in patients prior to hematopoietic stem-cell transplantation. Chest 128:145–152PubMedCrossRefGoogle Scholar
  15. 15.
    Piper BF, Dibble SL, Dodd MJ, Weiss MC, Slaughter RE, Paul SM (1998) The revised Piper Fatigue Scale: psychometric evaluation in women with breast cancer. Oncol Nurs Forum 25:677–684PubMedGoogle Scholar
  16. 16.
    Ministry of Health, Labour and Welfare, Japan (2008) The National Health and Nutrition Survey in Japan, 2008. (in Japanese). Available at: http://www.mhlw.go.jp/houdou/2009/11/h1109-1.html. Accessed June 5, 2010
  17. 17.
    Miyatake N, Saito T, Miyachi M, Tabata I, Numata T (2009) Evaluation of muscle strength and its relation to exercise habits in Japanese. Acta Med Okayama 63:151–155PubMedGoogle Scholar
  18. 18.
    Katoh M, Yamasaki H (2009) Comparison of reliability of isometric leg muscle strength measurements made using a hand-held dynamometer with and without a restraining belt. J Phys Ther Sci 21:37–42CrossRefGoogle Scholar
  19. 19.
    Katoh M, Yamasaki H (2009) Test-retest reliability of isometric leg muscle strength measurements made using a hand-held dynamometer restrained by a belt: comparisons during and between sessions. J Phys Ther Sci 21:239–243CrossRefGoogle Scholar
  20. 20.
    Hori N, Handa S, Yoshimoto Y, Katou K (2005) Measurements of isometric knee extention force with a hand-held dynamometer and COMBIT: study for validity and correlation by compared measure value. Nihon Shiritsu Ikadaigaku Zasshi 22:81–83Google Scholar
  21. 21.
    ATS statement: guidelines for the six-minute walk test (2002) Am J Respir Crit Care Med 166:111–117Google Scholar
  22. 22.
    Sciurba F, Criner G, Lee S, Mohsenifar Z, Shade D, Slivka W et al (2003) Six-minute walk distance in chronic obstructive pulmonary disease: reproducibility and effect of walking course layout and length. Am J Respir Crit Care Med 167:1522–1527PubMedCrossRefGoogle Scholar
  23. 23.
    Kervio G, Carre F, Ville N (2003) Reliability and intensity of the six-minute walk test in healthy elderly subjects. Med Sci Sports Exerc 35:169–174PubMedCrossRefGoogle Scholar
  24. 24.
    Poh H, Eastwood PR, Cecins NM, Ho KT, Jenkins SC (2006) Six-minute walk distance in healthy Singaporean adults cannot be predicted using reference equations derived from Caucasian populations. Respirology 11:211–216PubMedCrossRefGoogle Scholar
  25. 25.
    Fukuhara S, Suzukamo Y (2004) Manual of SF-36v2 Japanese version. Institute for Health Outcomes & Process Evaluation Research, KyotoGoogle Scholar
  26. 26.
    Fukuhara S, Ware JJ, Kosinski M, Wada S, Gandek B (1998) Psychometric and clinical tests of validity of the Japanese SF-36 Health Survey. J Clin Epidemiol 51:1045–1053PubMedCrossRefGoogle Scholar
  27. 27.
    Fukuhara S, Bito S, Green J, Hsiao A, Kurokawa K (1998) Translation, adaptation, and validation of the SF-36 Health Survey for use in Japan. J Clin Epidemiol 51:1037–1044PubMedCrossRefGoogle Scholar
  28. 28.
    Syrjala KL, Stover AC, Yi JC, Artherholt SB, Abrams JR (2010) Measuring social activities and social function in long-term cancer survivors who received hematopoietic stem cell transplantation. Psychooncology 19:462–471PubMedCrossRefGoogle Scholar
  29. 29.
    Guimarães F, Santos M, Oliveira E (2008) Quality of life of patients with autoimmune diseases submitted to bone marrow transplantation: a longitudinal study. Rev Lat Am Enferm 16:856–863CrossRefGoogle Scholar
  30. 30.
    Lau A, Chang C, Tai J, Eremenco S, Liang R, Lie A et al (2002) Translation and validation of the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) Version 4 quality of life instrument into traditional Chinese. Bone Marrow Transplant 29:41–49PubMedCrossRefGoogle Scholar
  31. 31.
    Miyamoto S, Nagaya N, Satoh T, Kyotani S, Sakamaki F, Fujita M et al (2000) Clinical correlates and prognostic significance of six-minute walk test in patients with primary pulmonary hypertension. Comparison with cardiopulmonary exercise testing. Am J Respir Crit Care Med 161:487–492PubMedGoogle Scholar
  32. 32.
    Knols R, de Bruin E, Aufdemkampe G, Uebelhart D, Aaronson N (2009) Reliability of ambulatory walking activity in patients with hematologic malignancies. Arch Phys Med Rehabil 90:58–65PubMedCrossRefGoogle Scholar
  33. 33.
    Dimeo F (2001) Effects of exercise on cancer-related fatigue. Cancer 92(6 Suppl):1689–1693PubMedCrossRefGoogle Scholar
  34. 34.
    Al-Majid S, Waters H (2008) The biological mechanisms of cancer-related skeletal muscle wasting: the role of progressive resistance exercise. Biol Res Nurs 10:7–20PubMedCrossRefGoogle Scholar
  35. 35.
    De Backer IC, Schep G, Hoogeveen A, Vreugdenhil G, Kester AD, van Breda E (2007) Exercise testing and training in a cancer rehabilitation program: the advantage of the steep ramp test. Arch Phys Med Rehabil 88:610–616PubMedCrossRefGoogle Scholar
  36. 36.
    De Backer IC, Vreugdenhil G, Nijziel MR, Kester AD, van Breda E, Schep G (2008) Long-term follow-up after cancer rehabilitation using high-intensity resistance training: persistent improvement of physical performance and quality of life. Br J Cancer 99:30–36PubMedCrossRefGoogle Scholar
  37. 37.
    Sutherland H, Fyles G, Adams G, Hao Y, Lipton J, Minden M et al (1997) Quality of life following bone marrow transplantation: a comparison of patient reports with population norms. Bone Marrow Transplant 19:1129–1136PubMedCrossRefGoogle Scholar
  38. 38.
    Hann D, Jacobsen P, Martin S, Kronish L, Azzarello L, Fields K (1997) Quality of life following bone marrow transplantation for breast cancer: a comparative study. Bone Marrow Transplant 19:257–264PubMedCrossRefGoogle Scholar
  39. 39.
    Meeske KA, Siegel SE, Globe DR, Mack WJ, Bernstein L (2005) Prevalence and correlates of fatigue in long-term survivors of childhood leukemia. J Clin Oncol 23:5501–5510PubMedCrossRefGoogle Scholar
  40. 40.
    Berger AM, Farr LA, Kuhn BR, Fischer P, Agrawal S (2007) Values of sleep/wake, activity/rest, circadian rhythms, and fatigue prior to adjuvant breast cancer chemotherapy. J Pain Symptom Manage 33:398–409PubMedCrossRefGoogle Scholar
  41. 41.
    Holzner B, Kemmler G, Kopp M, Nguyen-Van-Tam D, Sperner-Unterweger B, Greil R (2004) Quality of life of patients with chronic lymphocytic leukemia: results of a longitudinal investigation over 1 yr. Eur J Haematol 72:381–389PubMedCrossRefGoogle Scholar
  42. 42.
    Heinonen H, Volin L, Uutela A, Zevon M, Barrick C, Ruutu T (2001) Gender-associated differences in the quality of life after allogeneic BMT. Bone Marrow Transplant 28:503–509PubMedCrossRefGoogle Scholar
  43. 43.
    Socié G, Mary J, Esperou H, Robert D, Aractingi S, Ribaud P et al (2001) Health and functional status of adult recipients 1 year after allogeneic haematopoietic stem cell transplantation. Br J Haematol 113:194–201PubMedCrossRefGoogle Scholar
  44. 44.
    Calbet J, Lundby C, Koskolou M, Boushel R (2006) Importance of hemoglobin concentration to exercise: acute manipulations. Respir Physiol Neurobiol 151:132–140PubMedCrossRefGoogle Scholar
  45. 45.
    Dimeo F, Schwartz S, Fietz T, Wanjura T, Böning D, Thiel E (2003) Effects of endurance training on the physical performance of patients with hematological malignancies during chemotherapy. Support Care Cancer 11:623–628PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Shinichiro Morishita
    • 1
  • Katsuji Kaida
    • 2
  • Kazuhiro Ikegame
    • 2
  • Satoshi Yoshihara
    • 2
  • Kyoko Taniguchi
    • 2
  • Masaya Okada
    • 2
  • Norihiko Kodama
    • 3
  • Hiroyasu Ogawa
    • 2
  • Kazuhisa Domen
    • 3
  1. 1.Department of RehabilitationHyogo College of Medicine HospitalNishinomiyaJapan
  2. 2.Division of Hematology, Department of Internal MedicineHyogo College of MedicineNishinomiyaJapan
  3. 3.Department of Rehabilitation MedicineHyogo College of MedicineNishinomiyaJapan

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