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Lessons learned from a pilot randomized clinical trial of home-based exercise prescription before allogeneic hematopoietic cell transplantation

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Abstract

Allogeneic hematopoietic cell transplantation (alloHCT) is a life-saving technology that can cure otherwise incurable diseases, but imposes significant physiologic stress upon recipients. This stress leads to short-term toxicity and mid- to long-term physical function impairment in some recipients. Exercise interventions have demonstrated preliminary efficacy in preserving physical function in HCT recipients, but the role of these interventions prior to HCT (prehabilitative) is less known. We tested a 5- to 12-week, prehabilitative higher intensity home-based aerobic exercise intervention in a randomized study of alloHCT candidates. Of 113 patients screened, 34 were randomized to control or intervention groups, 16 underwent pre- and post-intervention peak oxygen consumption (VO2peak) testing, and 12 underwent pre- and post-intervention 6-min walk distance (6MWD) testing. No significant differences in VO2peak or 6MWD were seen pre- to post-intervention between intervention and control groups, but final numbers of evaluable participants in each group were too small to draw inferences regarding the efficacy of the intervention. We conclude that the design of our prehabilitative intervention was not feasible in this pilot randomized study, and make recommendations regarding the design of future exercise intervention studies in alloHCT.

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Funding

This work was supported in part by National Cancer Institute Grant 1R21CA192127-01A1.

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Authors and Affiliations

  1. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    William A. Wood, A. E. Smith-Ryan, E. D. Hanson, T. C. Shea & C. L. Battaglini

  2. Department of Mathematics and Statistics, Elon University, Elon, NC, USA

    M. Weaver

  3. Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    A. E. Smith-Ryan, E. D. Hanson & C. L. Battaglini

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  1. William A. Wood
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  2. M. Weaver
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Correspondence to William A. Wood.

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Wood, W.A., Weaver, M., Smith-Ryan, A.E. et al. Lessons learned from a pilot randomized clinical trial of home-based exercise prescription before allogeneic hematopoietic cell transplantation. Support Care Cancer 28, 5291–5298 (2020). https://doi.org/10.1007/s00520-020-05369-1

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