Determinants of cardiorespiratory fitness in very long-term survivors of allogeneic hematopoietic stem cell transplantation: a national cohort study
| Autor: | Phoi Phoi Diep, Lorentz Brinch, Ole Henrik Myrdal, Elisabeth Edvardsen, Liv Ingunn Bjoner Sikkeland, Richard Massey, Ellen Ruud, Johny Kongerud, May-Brith Lund |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Transplantation Conditioning Pulmonary function Adolescent medicine.medical_treatment Hematopoietic stem cell transplantation 030204 cardiovascular system & hematology Overweight Pulmonary function testing Cohort Studies Young Adult 03 medical and health sciences 0302 clinical medicine Deconditioning DLCO Internal medicine Humans Medicine Survivors Long-term follow-up business.industry Hematopoietic Stem Cell Transplantation Cardiac function VO2 max Cardiorespiratory fitness Middle Aged Survival Analysis humanities Cross-Sectional Studies Cardiorespiratory Fitness Oncology 030220 oncology & carcinogenesis Allogeneic hematopoietic stem cell transplantation Female Original Article medicine.symptom business Busulfan medicine.drug |
| Zdroj: | Supportive Care in Cancer |
| ISSN: | 1433-7339 0941-4355 |
| Popis: | PurposeSurvivors of allogeneic hematopoietic stem cell transplantation (allo-HSCT) are at risk for cardiopulmonary adverse events. Data on long-term effects on cardiorespiratory fitness are limited. To address the gap in knowledge, we aimed to determine peak oxygen uptake (V̇O2peak) and identify associations between cardiorespiratory fitness and clinical characteristics, self-reported physical activity, cardiac, and pulmonary function.MethodsIn a nationwide, single-center cross-sectional study, 90 survivors [aged median (range) 35 (17–54) years, 56% females] were examined, 17 (6–26) years after allo-HSCT. Myeloablative conditioning comprised busulfan/cyclophosphamide or cyclophosphamide only. Methods included pulmonary function tests, echocardiography, and cardiopulmonary exercise test.ResultsChronic graft-versus-host disease (cGVHD) was found in 31% of the subjects, of whom 40% had bronchiolitis obliterans syndrome (BOS). Seventy-one percent of the survivors did not meet WHO recommendations for physical activity and 42% were overweight. Reduced gas diffusion (DLCO) and systolic ventricular dysfunction (LVEF) were found in 44% and 31%, respectively. For the group, mean (95% CI), V̇O2peak was 36.4 (34.7–38.0) mL/min/kg [89 (85–93)% of predicted]. V̇O2peak was low at 43%. Cardiopulmonary factors and deconditioning were equally common limitations for exercise. In a multiple linear regression model, low V̇O2peak was associated with low DLCO, low LVEF, BOS, overweight, and inactivity.ConclusionHalf of the survivors had reduced cardiorespiratory fitness median 17 years after allo-HSCT. Cardiopulmonary factors and deconditioning were equally common limitations to exercise. We encourage long-term cardiopulmonary monitoring of allo-HSCT survivors and targeted advice on modifiable lifestyle factors. |
| Databáze: | OpenAIRE |
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