Frailty assessment and outpatient pre-habilitation for adults undergoing allogeneic hematopoietic cell transplantation.

This study reports the preliminary results of a Frailty program involving all allo-HCT candidates, initiated at our institution in April 2021. The program started with the assessment of patients' frailty at first consultation and at transplant admission using the HCT Frailty Scale. After observing the dynamics of the frailty syndrome, in June 2022 the program incorporated an individualized 4-8-weeks pre-habilitation program composed by personalized home-based exercise regimens to mitigate or prevent patients' frailty at transplantation. This study includes the 120 patients transplanted during the program, 58 of them participating in the pre-habilitation program. The results indicate that the distribution of frailty was the same in first consultation and at HCT admission in non-pre-habilitated patients, but it changed from the proportions of fit, pre-frail and frail patients of 22.8%, 66.7%, 10.5% at first consultation, to the proportions 45.6%, 50.9% and 3.5% (P = 0.041) at admission in the pre-habilitated ones. And that the likelihood of OS was lower in the frail than in the fit and the pre-frail groups (1-year OS: 45.7% vs. 77.2%, O = 0.021). Therefore, the study provides preliminary evidence that pre habilitation programs significantly reduces frailty among transplant candidates and, eventually, increase the likelihood of OS.