scholarly journals Financial impact of allogeneic hematopoietic cell transplantation on patients and families over 2 years: results from a multicenter pilot study

2016 ◽  
Vol 51 (9) ◽  
pp. 1233-1240 ◽  
Author(s):  
E M Denzen ◽  
V Thao ◽  
T Hahn ◽  
S J Lee ◽  
P L McCarthy ◽  
...  
Keyword(s):  
Pilot Study ◽  
Cell Transplantation ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Financial Impact ◽  
Allogeneic Hematopoietic Cell Transplantation

scholarly journals From frail to fit after allogeneic hematopoietic cell transplantation: Scope of the problem and a strength-based solution

2019 ◽  
Author(s):  
Jason Sweetnam ◽  
Eric Twohey ◽  
Sasha Skendzel ◽  
John Stingle ◽  
Mukta Arora ◽  
...  
Keyword(s):  
Pilot Study ◽  
Strength Training ◽  
Cell Transplantation ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Allogeneic Hematopoietic Cell Transplantation ◽  
Community Based ◽  
Allogeneic Hct ◽  
Long Term Survivors

AbstractBackgroundFrailty is a common but underdiagnosed syndrome among long-term survivors of allogeneic hematopoietic cell transplantation (HCT). Conditions such as malnutrition, fatigue, and weakness may suggest frailty despite patients not receiving a formal diagnosis. Furthermore, the optimal interventions to overcome frailty in long-term survivors of allogeneic HCT is not yet established.Patients and MethodsThis study consists of a retrospective and prospective component. First, we completed a retrospective review using diagnosis data from the electronic medical record to estimate the prevalence of components of frailty in 1077 recipients of allogeneic HCT through 5 years post-transplant. Second, we developed a community-based pilot study of strength training for long-term survivors of allogeneic HCT that addressed several common barriers exercise engagement and adherence. Four allogeneic HCT recipients (2 males, 2 females) and 4 controls (2 males, 2 females) completed the strength training pilot study, consisting of a baseline assessment, 10 weeks of personalized and supervised strength programming at least once weekly as a group, and an end-of-study assessment to measure progress in strength, body composition, and a standardized measure of self-efficacy.ResultsDespite a lack of a formal diagnosis, approximately 80% of HCT recipients in this series received a diagnosis of a component of frailty (weakness, fatigue, or malnutrition), and over 1/3 of HCT recipients had symptoms extending beyond 1 year. Over the course of the strength training pilot study, both pre-frail/frail allogeneic HCT recipients and healthy controls doubled their total strength, lost body fat, and gained muscle mass. Self-efficacy improved from baseline in allogeneic HCT recipients after the strength training pilot program.DiscussionBased upon the prevalence of frailty-related diagnoses among long-term survivors of HCT, a comprehensive mitigation strategy needs to be developed for this population. A community-based strength training program that includes a personalized component, a group setting, and caregiver/partner involvement appears feasible and overcomes several established barriers to exercise engagement and adherence.

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