title: Cardiopulmonary fitness in patients undergoing hematopoietic SCT: a pilot study.
abstract: Hematopoietic cell transplantation (HCT) is a life-saving treatment for patients with high-risk hematological malignancies. Prognostic measures to determine fitness for HCT are needed to inform decision-making and interventions. VO(2peak) is obtained by measuring gas exchange during cycle ergometry and has not been studied as a prognostic factor in HCT. Thirty-two autologous and allogeneic HCT patients underwent VO(2peak) and 6 Minute Walk (6MW) testing before HCT, and provided weekly symptom and health-related quality of life (HRQOL) assessments before HCT and concluding at Day 100. Twenty-nine patients completed pre-HCT testing. Pre-HCT VO(2peak) was positively correlated with pre-HCT 6MW (r=0.65, P<0.001) and negatively correlated with number of chemotherapy regimens and months of chemotherapy. Patients with lower VO(2peak) reported higher symptom burden and inferior HRQOL at baseline and during early post-HCT period. Patients with pre-HCT VO(2peak) <16 mL/kg/min had higher risk of mortality post HCT (entire cohort: hazard ratio (HR) 9.1 (1.75-47.0), P=0.01; allogeneic HCT patients only: HR 6.70 (1.29-34.75), P=0.02) and more hospitalized days before Day 100 (entire cohort: median 33 vs 19, P=0.003; allogeneic HCT patients only: median 33 vs 21, P=0.004). VO(2peak) pre-HCT is feasible and might predict symptom severity, HRQOL and mortality. Additional studies are warranted.
authors.affiliation: Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: W A
authors.initials: WA
authors.lastname: Wood
authors.forename: A M
authors.initials: AM
authors.lastname: Deal
authors.forename: B B
authors.initials: BB
authors.lastname: Reeve
authors.forename: A P
authors.initials: AP
authors.lastname: Abernethy
authors.forename: E
authors.initials: E
authors.lastname: Basch
authors.forename: S A
authors.initials: SA
authors.lastname: Mitchell
authors.forename: C
authors.initials: C
authors.lastname: Shatten
authors.forename: Y
authors.initials: Y
authors.lastname: Hie Kim
authors.forename: J
authors.initials: J
authors.lastname: Whitley
authors.forename: J S
authors.initials: JS
authors.lastname: Serody
authors.forename: T
authors.initials: T
authors.lastname: Shea
authors.forename: C
authors.initials: C
authors.lastname: Battaglini
mesh_terms: D000328:Adult; D000368:Aged; D002320:Cardiovascular Physiological Phenomena; D005080:Exercise Test; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D010865:Pilot Projects; D011788:Quality of Life; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods; D014184:Transplantation, Homologous