Effect of the severity of acute graft-versus-host disease on physical function after allogeneic hematopoietic stem cell transplantation

  • Ryota Hamada
  • Tadakazu KondoEmail author
  • Masanobu Murao
  • Jyunsuke Miyasaka
  • Michiko Yoshida
  • Manabu Nankaku
  • Junya Kanda
  • Akifumi Takaori-Kondo
  • Ryosuke Ikeguchi
  • Shuichi Matsuda
Original Article



The purpose of this study was to retrospectively investigate the effect of the severity of acute graft-versus-host disease (GVHD) on physical function after allogeneic hematopoietic stem cell transplantation (allo-HSCT).


76 patients were included as subjects of this study. Severity of acute GVHD was classified according to the method defined by Grucksberg. To evaluate physical function, the knee extensor strength and six-minute walk distance (6MWD) were performed.


Among these patients, 54% developed acute GVHD; of these, 32%, 54%, and 15% of patients had grade I, grade II, and grades III–IV GVHD, respectively. In the grade I–II groups, mild acute GVHD following allo-HSCT resulted in a gradual decline in physical function, which improved at discharge. However, in cases of severe acute GVHD, physical function deteriorated, implementation of rehabilitation became difficult, and the decline in physical function persisted even at discharge.


These results indicate that severe acute GVHD negatively affects physical function leading to longer hospital days because of inadequate rehabilitation interventions.


Allogeneic hematopoietic stem cell transplantation (allo-HSCT) Acute graft-versus-host disease (GVHD) Six-minute walk distance (6MWD) Knee extensor strength 



We are grateful to the medical, nursing, and laboratory staff of the participating departments for their contributions to this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Institutional Review Board of Kyoto University Hospital conducted in accordance with the international ethical recommendations stated in the Japanese Good Clinical Practice Guidelines.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Ryota Hamada
    • 1
  • Tadakazu Kondo
    • 2
    Email author
  • Masanobu Murao
    • 1
  • Jyunsuke Miyasaka
    • 1
  • Michiko Yoshida
    • 1
  • Manabu Nankaku
    • 1
  • Junya Kanda
    • 2
  • Akifumi Takaori-Kondo
    • 2
  • Ryosuke Ikeguchi
    • 1
  • Shuichi Matsuda
    • 1
  1. 1.Rehabilitation UnitKyoto University HospitalKyotoJapan
  2. 2.Department of Hematology and Oncology, Graduate School of MedicineKyoto UniversityKyotoJapan

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