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

Bone Marrow Transplantation volume 53, pages 281–290 (2018)Cite this article

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Abstract

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.

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Acknowledgements

This work was supported in part by Genavie Foundation. Pierre-Antoine Gourraud is supported by ATIP-Avenir INSERM program, the Nantes Metropole & Region Pays de Loire-ConnecTalent program and The Nantes University Foundation. The authors would like to acknowledge Dominique Issarni for her help in protocol set-up.

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Authors and Affiliations

  1. l’institut du thorax, UNIV Nantes, CHU Nantes, Nantes, 44000, France

    Stéphanie Dirou

  2. Laboratory “Movement, Interactions, Performance”, UNIV Nantes, CHU Nantes, Nantes, 44000, France

    Arnaud Chambellan

  3. Hematology, department Inserm UMR U892, CHU Nantes, Nantes, 44000, France

    Patrice Chevallier

  4. l’institut du thorax, CHU Nantes, Nantes, 44000, France

    Patrick Germaud

  5. l’institut du thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, Nantes, 44000, France

    Guillaume Lamirault, Béatrice Delasalle, Antoine Magnan, François-Xavier Blanc & Patricia Lemarchand

  6. Equipe ATIP-Avenir INSERM, UNIV Nantes, CHU Nantes, Nantes, 44000, France

    Pierre-Antoine Gourraud

  7. Department of Neurology, School of Medicine, University of California San Francisco, San Francisco, CA, 94158, USA

    Pierre-Antoine Gourraud

  8. Plateforme de biométrie, CHU Nantes, Nantes, 44000, France

    Bastien Perrot

  9. UNIV Nantes, CHU Nantes, Nantes, 44000, France

    Bastien Forestier

  10. Hematology department, CHU Nantes, Nantes, 44000, France

    Thierry Guillaume, Pierre Peterlin & Alice Garnier

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Dirou, S., Chambellan, A., Chevallier, P. et al. Deconditioning, fatigue and impaired quality of life in long-term survivors after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 53, 281–290 (2018). https://doi.org/10.1038/s41409-017-0057-5

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