scholarly journals Combined resistance and aerobic exercise intervention improves fitness, insulin resistance and quality of life in survivors of childhood haemopoietic stem cell transplantation with total body irradiation

2020 ◽  
Vol 67 (12) ◽  
Author(s):  
Nikki L. Davis ◽  
Keith Tolfrey ◽  
Meriel Jenney ◽  
Ruth Elson ◽  
Claire Stewart ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Insulin Resistance ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Total Body Irradiation ◽  
Exercise Intervention ◽  
Haemopoietic Stem Cell ◽  
Total Body ◽  
Haemopoietic Stem Cell Transplantation

Effects of a partly self-administered exercise program before, during, and after allogeneic stem cell transplantation

Blood ◽  
2011 ◽  
Vol 117 (9) ◽  
pp. 2604-2613 ◽  
Author(s):  
Joachim Wiskemann ◽  
Peter Dreger ◽  
Rainer Schwerdtfeger ◽  
Andrea Bondong ◽  
Gerhard Huber ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Physical Fitness ◽  
Cell Transplantation ◽  
Physical Performance ◽  
Exercise Intervention ◽  
Exercise Group ◽  
Psychologic Distress

Abstract Before, during, and after allogeneic hematopoietic stem cell transplantation (allo-HSCT), patients experience considerable physical and psychologic distress. Besides graft-versus-host disease and infections, reduced physical performance and high levels of fatigue affect patients' quality of life. This multicenter randomized controlled trial examined the effects of a partly self-administered exercise intervention before, during, and after allo-HSCT on these side effects. After randomization to an exercise and a social contact control group 105 patients trained in a home-based setting before hospital admission, during inpatient treatment and a 6- to 8-week period after discharge. Fatigue, physical performance, quality of life, and physical/psychologic distress were measured by standardized instruments at baseline, admission to, and discharge from hospital and 6 to 8 weeks after discharge. The exercise group showed significantly improvement in fatigue scores (up to 15% improvement in exercise group vs up to 28% deterioration in control; P < .01-.03), physical fitness/functioning (P = .02-.03) and global distress (P = .03). All effects were at least detectable at one assessment time point after hospitalization or repeatedly. Physical fitness correlated significantly with all reported symptoms/variables. In conclusion, this partly supervised exercise intervention is beneficial for patients undergoing allo-HSCT. Because of low personnel requirements, it might be valuable to integrate such a program into standard medical care.

scholarly journals Metreleptin Supplementation for Improving Lipid and Glycemic Profiles in Acquired Diabetes Lipodystrophy: A Case Report

2019 ◽  
Vol 3 (11) ◽  
pp. 2179-2183
Author(s):  
Ayako Nagayama ◽  
Kenji Ashida ◽  
Kanoko Moritaka ◽  
Mami Hidaka ◽  
Mizuki Gobaru ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Stem Cell ◽  
Insulin Sensitivity ◽  
Stem Cell Transplantation ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Total Body Irradiation ◽  
Childhood Cancer Survivors ◽  
Total Body

Abstract Most childhood cancer survivors who undergo hematopoietic stem cell transplantation subsequently develop impaired glucose tolerance and hypertriglyceridemia. These conditions are presumably associated with total-body irradiation–related acquired lipodystrophy and may lead to cardiovascular disease. Metreleptin (recombinant leptin) may help improve the lipoprotein profile, insulin sensitivity, and quality of life of patients with total-body irradiation-related lipodystrophy. This report describes the safe and effective use of metreleptin supplementation for insulin resistance and dyslipidemia in acquired incomplete lipodystrophy. A 24-year-old Japanese woman with diabetes mellitus and hypertriglyceridemia was admitted to our hospital. She was diagnosed with acute lymphocytic leukemia at 3 years of age and had undergone systemic chemotherapy and total-body irradiation before allogeneic stem cell transplantation. She was also diagnosed with hypertriglyceridemia and diabetes mellitus at 11 years of age. She had a low adiponectin level, low-normal leptin level, and diabetes mellitus with marked insulin resistance. Thus, acquired incomplete lipodystrophy was diagnosed. Her serum triglyceride and lipoprotein profiles improved within 1 month of treatment initiation. Glycemic metabolism and insulin sensitivity in the skeletal muscles improved after 6 months. As previously reported, metreleptin therapy is effective in improving lipid and glycemic profiles in generalized lipodystrophy. In the present case, we considered that metreleptin supplementation could reduce the remnant VLDL cholesterol fraction and improve diabetes mellitus. We conclude that it may be an effective alternative therapy for improving the expected prognosis of patients with acquired incomplete lipodystrophy, including childhood cancer survivors.

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