title: Exercise and stress management training prior to hematopoietic cell transplantation: Blood and Marrow Transplant Clinical Trials Network (BMT CTN) 0902.
abstract: Studies show that engaging patients in exercise and/or stress management techniques during hematopoietic cell transplantation (HCT) improves quality of life. The Blood and Marrow Transplant Clinical Trials Network tested the efficacy of training patients to engage in self-directed exercise and stress management during HCT. The study randomized 711 patients at 21 centers to receive 1 of 4 training interventions before HCT: a self-directed exercise program, a self-administered stress management program, both, or neither. Participants completed self-reported assessments at enrollment and up to 180 days after HCT. Randomization was stratified by center and transplant type. There were no differences in the primary endpoints of the Physical Component Summary and Mental Component Summary scales of the Medical Outcomes Study Short Form 36 at day +100 among the groups, based on an intention-to-treat analysis. There also were no differences in overall survival, days of hospitalization through day +100 post-HCT, or in other patient-reported outcomes, including treatment-related distress, sleep quality, pain, and nausea. Patients randomized to training in stress management reported more use of those techniques, but patients randomized to training in exercise did not report more physical activity. Although other studies have reported efficacy of more intensive interventions, brief training in an easy-to-disseminate format for either self-directed exercise or stress management was not effective in our trial.
authors.affiliation: Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Jacobsen
authors.affiliation: Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Le-Rademacher
authors.affiliation: Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida.
authors.forename: Heather
authors.initials: H
authors.lastname: Jim
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Karen
authors.initials: K
authors.lastname: Syrjala
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, University of Florida College of Medicine, Gainesville, Florida.
authors.forename: John R
authors.initials: JR
authors.lastname: Wingard
authors.affiliation: Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Brent
authors.initials: B
authors.lastname: Logan
authors.affiliation: The EMMES Corporation, Washington, DC.
authors.forename: Juan
authors.initials: J
authors.lastname: Wu
authors.affiliation: Blood and Marrow Transplant Program, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Navneet S
authors.initials: NS
authors.lastname: Majhail
authors.affiliation: Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: William
authors.initials: W
authors.lastname: Wood
authors.affiliation: Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: J Douglas
authors.initials: JD
authors.lastname: Rizzo
authors.affiliation: Office of Biostatistics Research, National Heart, Lung, and Blood Institute, Bethesda, Maryland.
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Geller
authors.affiliation: Pediatric Blood and Marrow Transplant Program, University of Michigan, Ann Arbor, Michigan.
authors.forename: Carrie
authors.initials: C
authors.lastname: Kitko
authors.affiliation: Division of Hematology/Oncology, University of Nebraska Medical Center, Omaha, Nebraska.
authors.forename: Edward
authors.initials: E
authors.lastname: Faber
authors.affiliation: Department of Medical Oncology, Wayne State University/Karmanos Cancer Institute, Detroit, Michigan.
authors.forename: Muneer H
authors.initials: MH
authors.lastname: Abidi
authors.affiliation: Center for Hematologic Malignancies, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon.
authors.forename: Susan
authors.initials: S
authors.lastname: Slater
authors.affiliation: Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Horowitz
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington. Electronic address: sjlee@fhcrc.org.
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005081:Exercise Therapy; D005260:Female; D019337:Hematologic Neoplasms / Q000276:immunology / Q000401:mortality / Q000523:psychology* / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000627:therapeutic use; D011379:Prognosis; D011788:Quality of Life; D057566:Self Report; D013315:Stress, Psychological / Q000628:therapy*; D016019:Survival Analysis; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous
chemical_list: D019653:Myeloablative Agonists
keywords: Allogeneic hematopoietic cell transplantation; Autologous hematopoietic cell transplantation; Exercise; Quality of life; Stress management