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接受异基因造血干细胞移植患者的身体功能、肌肉质量和生活质量的恢复

Recovery of physical function, muscle mass, and quality of life in patients undergoing allogeneic hematopoietic stem cell transplantation.

作者信息

Takekiyo Takahiro, Utsunomiya Atae, Nara Souichiro, Nakashima Norihisa, Okamura Toshiyuki, Tokunaga Masahito, Miyazono Takayoshi, Nakano Nobuaki, Ito Yoshikiyo, Dozono Koichiro

机构信息

Department of Rehabilitation, Imamura General Hospital, Kagoshima, Japan.

Department of Hematology, Imamura General Hospital, Kagoshima, Japan.

出版信息

Blood Cell Ther. 2024 May 31;7(3):64-74. doi: 10.31547/bct-2023-034. eCollection 2024 Aug 25.

Abstract

This study aimed to investigate the recovery of physical function, muscle mass, and quality of life (QOL) in allogeneic hematopoietic stem cell transplantation (allo-HSCT) patients 1 year after the procedure. A total of 71 patients who underwent allo-HSCT at our institution between February 2010 and June 2020, for whom a physical therapy assessment could be performed before allo-HSCT, at discharge, and 1 year after the procedure, were included. Exercise therapy during hospitalization was provided individually by a physical therapist, and exercise was self-administered after discharge. One year after allo-HSCT, handgrip strength and results of the 6-minute walk test recovered to pre-HSCT levels. However, muscle mass 1 year after allo-HSCT did not reach the pre-HSCT level. All subscales of QOL, 1 year after allo-HSCT, recovered to pre-HSCT levels, but only two of the eight subscales recovered to the national standard of 50. Multivariate analysis revealed factors associated with the recovery of physical function, muscle mass, and QOL, hemoglobin levels and albumin levels, especially among men. In contrast, factors that negatively affected recovery were age, acute graft-versus-host disease, and pre-HSCT intensity conditioning. The results suggest a potential recovery in handgrip strength, endurance, and QOL 1 year after allo-HSCT.

摘要

本研究旨在调查异基因造血干细胞移植(allo-HSCT)患者在该手术后1年时身体功能、肌肉量和生活质量(QOL)的恢复情况。纳入了2010年2月至2020年6月期间在本机构接受allo-HSCT的71例患者,这些患者在allo-HSCT前、出院时以及手术后1年均可进行物理治疗评估。住院期间的运动疗法由物理治疗师个体化提供,出院后患者自行进行运动。allo-HSCT后1年,握力和6分钟步行试验结果恢复到HSCT前水平。然而,allo-HSCT后1年的肌肉量未达到HSCT前水平。allo-HSCT后1年,QOL的所有子量表均恢复到HSCT前水平,但八个子量表中只有两个恢复到国家标准50。多变量分析揭示了与身体功能、肌肉量和QOL恢复相关的因素,尤其是男性中的血红蛋白水平和白蛋白水平。相比之下,对恢复产生负面影响的因素是年龄、急性移植物抗宿主病和HSCT前的强化预处理。结果表明,allo-HSCT后1年握力、耐力和QOL有潜在的恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7953/11384126/7b0bc9a7a2fb/2432-7026-7-3-0064-g001.jpg

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