Feasibility and safety of exercise training and nutritional support prior to haematopoietic stem cell transplantation in patients with haematologic malignancies

Prehabilitation with regular exercise and nutritional care for patients undergoing surgeries for malignant disease was recently introduced to increase physiologic reserve prior to the procedure, accelerate recovery and improve outcomes. This study aimed to investigate the feasibility and safety of c...

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Bibliographic Details
Published in:BMC cancer 2020-11, Vol.20 (1), p.1142-1142, Article 1142
Main Authors: Rupnik, Erik, Skerget, Matevz, Sever, Matjaz, Zupan, Irena Preloznik, Ogrinec, Maja, Ursic, Barbara, Kos, Natasa, Cernelc, Peter, Zver, Samo
Format: Article
Language:English
Subjects:
Blood cancer
Blood diseases
Body mass index
Body weight
Care and treatment
Diagnosis
Dietary supplements
Exercise
Exercise Therapy - methods
Fat-free body mass
Feasibility Studies
Female
Fitness training programs
Follow-Up Studies
Health aspects
Health Status
Heart rate
Hematologic Neoplasms - rehabilitation
Hematologic Neoplasms - therapy
Hematopoietic Stem Cell Transplantation - methods
Hematopoietic stem cells
Humans
Male
Medical nutrition therapy
Metabolism
Methods
Middle Aged
Muscle strength
Nausea
Nutrition
Nutritional status
Nutritional Support
Patient outcomes
Patients
Physical fitness
Physical training
Pilot Projects
Prognosis
Protein synthesis
Proteins
Public health
Quality of life
Safety
Sleep disorders
Stem cell transplantation
Stem cells
Surgery
Transplantation
Walking
Whey protein
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Summary:Prehabilitation with regular exercise and nutritional care for patients undergoing surgeries for malignant disease was recently introduced to increase physiologic reserve prior to the procedure, accelerate recovery and improve outcomes. This study aimed to investigate the feasibility and safety of combined exercise training and nutritional support in patients with haematologic malignancies prior to haematopoietic stem cell transplantation (HSCT). In this single-arm pilot study, 34 HSCT candidates were enrolled at least two weeks before admission for the procedure. Patients performed aerobic exercises at least 4 days per week for 20-30 min and strength exercises 3 days per week for 10-20 min. They received daily supplements of whey protein (0.3-0.4 g/kg body weight) and oral nutritional supplements if needed. The primary endpoints were feasibility (acceptability > 75%, attrition  66%) and safety. The secondary endpoints were fat-free mass (FFM), muscle strength, physical performance and health-related quality of life (HRQoL) at HSCT. The rate of acceptability, attrition and adherence to aerobic exercise, strength exercise and protein supplement consumption was 82.4, 17.8, 71, 78 and 80%, respectively. No severe adverse events were reported. Twenty-eight patients participated in the study for a median of 6.0 weeks (range, 2-14). They performed aerobic exercises 4.5 days per week for 132 min per week and strength exercises 3.0 times per week. Patients consumed 20.7 g of extra protein daily. At the end of the programme, we recorded increases of 1.1 kg in FFM (p = 0.011), 50 m in walking distance in the 6-min walking test (6MWT) (p 
ISSN:1471-2407
1471-2407
DOI:10.1186/s12885-020-07637-z