Exercise during hematopoietic stem cell transplant hospitalization in children.
OBJECTIVE
The purpose of this controlled trial was to assess the effect of an approximately 3-wk intrahospital exercise intervention performed during inpatient hospitalization for pediatric allogeneic hematopoietic stem cell transplant (HSCT) on (i) immune cell recovery and (ii) body composition.


METHODS
Immune (i.e., blood counts of leukocytes, monocytes, lymphocytes, and lymphocyte subpopulations) and anthropometric variables (i.e., body mass, body mass index, and estimated fat-free mass) were measured before and after (+15 and 30 d) HSCT. Seven children (5 boys and 2 girls; age (mean +/- SD) = 8 +/- 4 yr) with high-risk cancer performed an individualized training program (aerobic + resistance exercises) in their isolated hospital rooms. We also assessed a control group (n = 13; 9 boys and 4 girls; age = 7 +/- 3 yr) with similar medical conditions and following the same transplant protocol.


RESULTS
In both groups, the dendritic cell count decreased from pre-HSCT to +15 d post-HSCT and thereafter (up to +30 d) remained stabile; however, the posttransplant decrease was more abrupt in the control group than that in the intervention group (-87% vs -63%, respectively, from pre-HSCT to +15 d). The rest of the immune cell parameters measured showed a similar response from pre-HSCT to post-HSCT in both groups. We found a significant effect of the interaction group x time for all anthropometric variables (weight, body mass index, body fat, and fat-free mass), indicating an increase over the hospitalization period only in the intervention group, for example, body mass increased from 32.9 +/- 18.7 kg pre-HSCT to 35.4 +/- 18.6 kg at +30 d in the intervention group versus a decrease from 30.2 +/- 16.6 to 29.3 +/- 6.3 kg in the control group.


CONCLUSIONS
Our findings support the feasibility of exercise training interventions during hospitalization, including immunocompromised children.
Chamorro-Viña
Carolina
C
European University of Madrid, Madrid, Spain.
Ruiz
Jonatan R
JR
Santana-Sosa
Elena
E
González Vicent
Marta
M
Madero
Luis
L
Pérez
Margarita
M
Fleck
Steven J
SJ
Pérez
Antonio
A
Ramírez
Manuel
M
Lucía
Alejandro
A
D015992:Body Mass Index; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D003713:Dendritic Cells; D005260:Female; D006085:Graft Survival / Q000276:immunology*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007297:Inpatients; D007694:Killer Cells, Natural; D008297:Male; D055070:Resistance Training