Dirou S; Chambellan A; Chevallier P; Germaud P; Lamirault G; Gourraud PA;
Perrot B; Delasalle B; Forestier B; Guillaume T; Peterlin P; Garnier A;
Magnan A; Blanc FX; Lemarchand P.

Bone Marrow Transplantation. 53(3):281-290, 2018 03.

Long-term survivors after allogeneic hematopoietic stem cell
transplantation (allo-HSCT) are at high risk for treatment-related adverse
events, that may worsen physical capacity and may induce fatigue and
disability. The aims of this prospective study were to evaluate exercise
capacity in allotransplant survivors and its relationship with fatigue and
disability. Patient-reported outcomes and exercise capacity were evaluated
in 71 non-relapse patients 1 year after allo-HSCT, using validated
questionnaires, cardiopulmonary exercise testing (CPET) with measure of
peak oxygen uptake (peakVO2) and deconditioning, pulmonary function
testing, echocardiography and 6-min walk test. A high proportion (75.4%)
of allo-HSCT survivors showed abnormal cardiopulmonary exercise testing
parameters as compared to predicted normal values, including 49.3%
patients who exhibited moderate to severe impairment in exercise capacity
and 37.7% patients with physical deconditioning. PeakVO2 values were not
accurately predicted by 6-min walk distances (r = 0.53). Disability and
fatigue were strongly associated with decreased peakVO2 values (p = 0.002
and p = 0.008, respectively). Exercise capacity was reduced in most
allo-HSCT long-term survivors. Because reduced exercise capacity was
associated with fatigue, disability and a decrease in quality of life,
cardiopulmonary exercise testing should be performed in every patient who
reports fatigue and disability.