Impact of HSCT Conditioning and Glucocorticoid Dose on Exercise Adherence and Response.

Purpose: Evidence from randomized controlled trials (RCT) is growing that exercise interventions have beneficial effects in patients undergoing allogeneic stem cell transplantation (allo-HSCT). However, intensive chemotherapy conditioning as well as glucocorticoid (GC) treatment is always part of an allo-HSCT and possibly impact exercise adherence and training response. Therefore, we aimed to examine whether various conditioning protocols or different doses of GC treatment affect exercise adherence and/or training response during the inpatient period. Methods: We analyzed inpatient data from intervention groups of two large RCTs in allo-HSCT patients (n=113). The intervention incorporated partly supervised endurance and resistance exercise 3-5x/week. According to the potentially interfering factors patients were divided into groups depending on intensity of conditioning (myeloablative conditioning (MAC), reduced-intensity conditioning (RIC) and nonmyeloablative conditioning (NMC)) and cumulative dose of GC treatment (GC LOW 9 mg/kg prednisone) and were compared. Results: Median exercise adherence (target value 5 sessions weekly) during the inpatient period was 64% in MAC, 54% in RIC and 63% in NMC. The proportion of prematurely terminated training sessions ranged from 11% to 15%. Tiredness was the most frequent cause of exercise termination in all groups. Exercise adherence, duration (minutes/week) and type of training was significantly associated with GC dose. With regard to training response, results suggest GC LOW patients tend to respond better in knee extensor muscle strength. Conclusions: Exercise adherence during inpatient period is significantly impacted by dose of GC treatment but not by condition regimen. However, given the reasonable adherence rates also in the GC HIGH group data supports the feasibility and importance of exercising for all allo-HSCT patients during the inpatient period. (C) 2017 American College of Sports Medicine

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