Post-transplant changes in physical functioning and quality of life in patients undergoing two allogeneic hematopoietic stem cell transplants

Abstract

This study retrospectively examined changes in physical functioning and quality of life (QOL) in allogeneic hematopoietic stem cell transplantation (HSCT) recipients at their first (HSCT-1) and second (HSCT-2) transplantations. Seventeen patients who underwent HSCT-2 after relapse following HSCT-1 at our hospital between May 2013 and November 2023 and who underwent physical therapy evaluations before and after both transplantations were analyzed. Physical functioning was evaluated using handgrip strength as a measure of muscle strength, and exercise tolerance using the 6-min walk test (6MWT). QOL was assessed using the Medical Outcome Study 36-Item Short Form Health Survey (SF-36). Changes in physical functioning included handgrip strength (HSCT-1: - 9.3%; HSCT-2: - 18.3%; p < 0.05) and 6MWT findings (HSCT-1: - 5.1%; HSCT-2: - 12.6%; p < 0.05), which showed a significantly greater decline at HSCT-2. Physical functioning scores (SF-36) showed changes in QOL (HSCT-1: - 4.3 points; HSCT-2: - 23.4 points; p < 0.05), with a significantly greater reduction at HSCT-2. The findings indicate that the decline in physical functioning and QOL was more pronounced during the second transplantation than during the first. This highlights the importance of prioritizing strategies to maintain physical activity levels, particularly during the second transplantation process.

Keywords: Exercise therapy; Physical functioning change; Quality of life; Second allogeneic hematopoietic stem cell transplantation.