Limbach Matthias, Kuehl Rea, Koeppel Maximilian, Dreger Peter, Luft Thomas, Bohus Martin, Wiskemann Joachim
Department of Medical Oncology, Heidelberg University Hospital and National Center for Tumor Diseases Heidelberg, a partnership between German Cancer Research Center (DKFZ) and University Medical Center Heidelberg, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany.
Institute of Sports and Sport Science, Heidelberg University, Im Neuenheimer Feld 700, Heidelberg, Germany.
Support Care Cancer. 2025 Jan 10;33(2):89. doi: 10.1007/s00520-024-09140-8.
Physical performance is crucial for prognosis after allogeneic hematopoietic stem cell transplantation (allo-HCT). Cardiorespiratory fitness has already been shown to have prognostic value, and there is increasing evidence that muscle strength and associated parameters (e.g., sarcopenia) are also of clinical relevance. Therefore, there is a need for the quantification of muscle strength and defining risk factors for reduced performance values.
Maximal voluntary isokinetic (MVIC) and isometric (MIPT) muscle strength was assessed 2.4 ± 7.1 days prior admission for allo-HCT with a stationary isokinetic testing machine (IsoMed2000). We calculated percentiles for knee extension and hip flexion using healthy reference values. Regression models were used to identify predictors for reduced muscle strength including gender, age, body mass index (BMI), number of previous cardiotoxic therapies, number of previous transplantations, comorbidity index (HCT-CI), hemoglobin level, and physical activity.
Data of 212 patients (male n = 143, female n = 69), with a mean age of 54.49 ± 11.4, revealed considerably deviations from healthy reference values. Patients were located in the following percentiles: MVIC 37.5 ± 30.3, MVIC 39.5 ± 31.3 and MIPT 22.9 ± 26.5; MIPT 22.6 ± 27.4. Sub-group analyses showed that patients with younger age and male gender possess the highest deviations. Muscle strength values were significantly (p < 0.05) influenced by age, female gender, lower BMI, and higher HCT-CI.
Muscle strength is considerably reduced immediately prior to allo-HCT. Identified patient characteristics for reduced muscle strength point to the population that should be primarily targeted with exercise respectively resistance training interventions prior to allo-HCT to contribute to a well prepared transplant candidate.
NCT01374399.
体能对异基因造血干细胞移植（allo-HCT）后的预后至关重要。心肺适能已被证明具有预后价值，并且越来越多的证据表明肌肉力量及相关参数（如肌肉减少症）也具有临床相关性。因此，需要对肌肉力量进行量化，并确定表现值降低的风险因素。
在allo-HCT入院前2.4±7.1天，使用固定等速测试机（IsoMed2000）评估最大自主等速（MVIC）和等长（MIPT）肌肉力量。我们使用健康参考值计算膝关节伸展和髋关节屈曲的百分位数。回归模型用于确定肌肉力量降低的预测因素，包括性别、年龄、体重指数（BMI）、既往心脏毒性治疗次数、既往移植次数、合并症指数（HCT-CI）、血红蛋白水平和身体活动情况。
212例患者（男性n = 143，女性n = 69）的数据显示，平均年龄为54.49±11.4岁，与健康参考值有显著偏差。患者的百分位数如下：MVIC为37.5±30.3，MVIC为39.5±31.3，MIPT为22.9±26.5；MIPT为22.6±27.4。亚组分析表明，年龄较小和男性患者的偏差最大。肌肉力量值受到年龄、女性性别、较低的BMI和较高的HCT-CI的显著（p < 0.05）影响。
allo-HCT前肌肉力量明显降低。确定的肌肉力量降低的患者特征指出了在allo-HCT前应主要针对其进行运动或抗阻训练干预的人群，以帮助患者做好移植准备。
NCT01374399。
