Conference Coverage

Study shows value of pretransplant assessment of function, endurance



– Comprehensive assessment of functional status and endurance prior to allogeneic hematopoietic cell transplantation (HCT) provides important insights into posttransplant outcomes, and when used in combination with other measures may improve the patient selection process, a chart review suggests.

In 349 patients, results of the prospective assessment of physical performance and endurance, along with HCT Comorbidity Index (HCT-CI) score and Karnofsky Performance Scale score (KPS), were compared with day 100-plus nonrelapse mortality and overall survival. The measures were also compared with the novel measures of hospital length of stay, and death during HCT admission, Shabnam Rehman, MD, reported at the combined annual meetings of the Center for International Blood & Marrow Transplant Research and the American Society for Blood and Marrow Transplantation.

Patients undergo physical therapy FatCamera/Getty Images
Age, gender, race, disease, and conditioning regimen were not associated with the novel outcomes of length of stay, inpatient death, or day 100-plus nonrelapse mortality, said Dr. Rehman, a hematology-oncology fellow at Roswell Park Cancer Institute, Buffalo, N.Y.

However, heart rate recovery in less than 3 minutes after performing 25 step-ups on each side was associated with shorter length of stay with 89% of those patients, compared with 11% of patients who were not able to recover their heart rate in less than 3 minutes, being discharged within 30 days, she said.

“Similarly, patients who are able to perform at least 11 sit-to-stands in 30 seconds are more likely to be discharged earlier (63% vs. 14% discharged within 30 days),” she said. “The converse is also true.”

That is, only 16% of those not able to recover their heart rate within 3 minutes had a 30-day or shorter stay, while 31% had at least a 60-day stay. In addition, just 13% of those with limited endurance had a 30-day stay or shorter, while 24% had at least a 60-day stay, she explained.

Further, patients with limited endurance, and those unable to perform 10 or more sit-to-stands in 30 seconds were more likely to die during their first transplant admission. Of those with limited endurance, 31% died during admission and 13% survived, and of those with good endurance 69% died during admission and 87% survived. Among patients who were unable to perform more than 10 sit-to-stands, 42% died during admission and 20% survived, and of those able to perform 11 or more, 38% died during admission, and 53% survived.


Next Article: