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Muscle oxygen extraction and lung function are related to exercise tolerance after allogeneic hematopoietic stem cell transplantation

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A Correction to this article was published on 20 April 2021

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Abstract

Purpose

This study aimed to investigate the relationship between exercise intolerance, muscle oxidative metabolism, and cardiopulmonary function following allogeneic hematopoietic stem cell transplantation (allo-HSCT) in a sterile isolation room setting.

Methods

This was a prospective observational cohort study conducted in a single center. Fourteen patients with hematopoietic malignancies who had undergone allo-HSCT were included in this study from June 2015 to April 2020. Patients received donor HSCT after high dose-chemotherapy and total-body irradiation. Physical activity was limited during treatments. Outcome measures included body anthropometric measurements, exercise tolerance tests using the ramp protocol, pulmonary function tests, and near-infrared spectroscopy (NIRS) measurements. Data of pre- and posttransplant measurements were compared using the paired t test or nonparametric Wilcoxon U test. Associations were assessed using the Pearson or nonparametric Spearman correlations.

Results

NIRS showed reduced muscle consumption and extraction of oxygen in the posttransplant period compared to the pretransplant period (ΔStO2 min pre: −18.6% vs. post: −13.0%, P = 0.04; ΔHHb max pre: 4.21μmol/l vs. post: 3.31μmol/l: P = 0.048). Exercise tolerance had reduced following allo-HSCT (Peak workload pre: 70.3 W vs. post: 58.0 W: P = 0.014). Furthermore, exercise intolerance was associated with pulmonary function, muscle oxygen consumption, and muscle oxygen extraction (all P <0.05).

Conclusion

This analysis revealed that exercise intolerance following allo-HSCT was associated with pulmonary dysfunction and muscle oxidative dysfunction. These findings could help identify the physical function associated with impaired tissue oxygen transport leading to exercise intolerance following allo-HSCT.

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Acknowledgements

We thank Professor Ogawa for his helpful advice on study design.

Funding

This study was funded by a Grant-in-Aid for KAKENHI (grant numbers: 18H00508, 17H00696, 16H00708) from the Ministry of Sports Science and Technology, Japan.

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Authors and Affiliations

  1. Department of Rehabilitation, Hyogo College of Medicine College Hospital, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan

    Tatsushi Wakasugi

  2. Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan

    Shinichiro Morishita

  3. Department of Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan

    Shinichiro Morishita, Yuki Uchiyama & Kazuhisa Domen

  4. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan

    Katsuji Kaida & Kazuhiro Ikegame

Authors
  1. Tatsushi Wakasugi
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  2. Shinichiro Morishita
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  3. Katsuji Kaida
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  4. Kazuhiro Ikegame
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  5. Yuki Uchiyama
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  6. Kazuhisa Domen
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Contributions

T.W, S.M, K.K, K.I, Y.U, and K.D contributed to conceptualization and data curation. T.W contributed to the evaluation of physical function and NIRS. T.W contributed to the analysis of NIRS. All authors contributed to the writing of the original draft, review, and editing. K.D contributed to the final approval of the article.

Corresponding author

Correspondence to Tatsushi Wakasugi.

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Ethics approval

This study was approved by the ethics committee, Institutional Committee for Human Research of Hyogo College of Medicine (No: 2318). The research was conducted in accordance with the Declaration of Helsinki, 1964.

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Written informed consent was obtained from all individual participants included in the study.

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Patients signed informed consent regarding publishing their data.

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The authors declare no competing interests.

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The original version of this article was revised. Affiliations 1 and 3 are incorrect.

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Wakasugi, T., Morishita, S., Kaida, K. et al. Muscle oxygen extraction and lung function are related to exercise tolerance after allogeneic hematopoietic stem cell transplantation. Support Care Cancer 29, 6039–6048 (2021). https://doi.org/10.1007/s00520-021-06178-w

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