Cardiorespiratory fitness in long-term lymphoma survivors after high-dose chemotherapy with autologous stem cell transplantation

Stenehjem, Jo S; Smeland, Knut B; Murbraech, Klaus; Holte, Harald;
Kvaløy, Stein; Thorsen, Lene; Arbo, Ingerid; Jones, Lee W; Aakhus,
Svend; Lund, May Brit; Kiserud, Cecilie E.

British Journal of Cancer,
July 2016, Vol. 115 Issue: Number 2 p178-187, 10p;

Background:Cardiorespiratory fitness as measured by peak oxygen
consumption (VO2peak) is a strong predictor of longevity and may be
compromised by anticancer therapy, inactivity, and smoking. We compared
VO2peakamong lymphoma survivors (LSs) with reference data from healthy
sedentary subjects, after a 10.2-year (mean) follow-up post high-dose
chemotherapy with autologous stem cell transplantation (HDT-ASCT). We
further examined the association between VO2peakand treatment, physical
activity, smoking, pulmonary, and cardiac function.

survivors treated with HDT-ASCT in Norway 1987–2008 were eligible.
VO2peakwas assessed by cardiopulmonary exercise testing. Pulmonary
function testing and echocardiography were also conducted. Data on
treatment, physical activity, and smoking were collected from hospital
records and questionnaires. VO2peakwas compared with age–sex predicted
reference data. Linear regression was used to associate clinical
factors with VO2peakcross-sectionally.Results:A total of 194 LSs
without heart failure were studied. Mean VO2peakwas 4.5% and 7.7% below
norms in females and males, respectively. Twenty-two percent had
impaired (<80% predicted) VO2peak. Decreasing VO2peakwas associated
with impaired diffusion capacity and current smoking, while physical
activity level and VO2peakwere positively associated.Conclusion:We
suggest increased attention towards physical activity counseling and
smoking cessation advice to preserve cardiorespiratory fitness in LSs
after HDT-ASCT. Patients with impaired diffusion capacity may benefit
from subsequent monitoring to detect pulmonary vascular diseases.