Deconditioning, fatigue and impaired quality of life in long-term survivors after allogeneic hematopoietic stem cell transplantation.

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 Transplant. 2018 Mar;53(3):281-290. doi: 10.1038/s41409-017-0057-5.
Epub 2017 Dec 21.

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.