Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Exercise Training Improves Persistent Fatigue Following Allogeneic Haematopoietic Stem Cell Transplantation – A Prospective Pilot Study  (#453)

Genevieve Douglas 1 , Alicia Orr 1 , Zosha Jarecki-Warke 2 , Eric Wong 1 , Ashley Bigaran 2 3
  1. Department of Clinical Haematology, Austin Health, Heidelberg, VIC, Australia
  2. Wellness and Supportive Care, Olivia Newton John Cancer Wellness and Research Centre, Austin Health , Heidelberg, VIC, Australia
  3. Department of Surgery , Austin Precinct, The University of Melbourne, Melbourne , VIC, Australia

Background

Allogeneic haematopoietic stem cell transplantation (AlloHSCT) is a critical therapy providing long-term control of haematologic cancers; however long-lasting, debilitating fatigue is common, associated with reduced quality-of-life (QoL) and cardiorespiratory fitness. Exercise interventions have been shown to improve fatigue, QoL and cardiorespiratory fitness, however, few studies have examined feasibility or efficacy >6 months after alloHSCT. We aimed to determine feasibility of an eight-week, tailored exercise training program for patients with persistent fatigue >6 months after alloHSCT. 

Methods

Prospective, single-site, single-arm pilot, recruited participants >6 months after alloHSCT (transplanted November 2018 – July 2022) with fatigue symptoms. Participants performed a twice-weekly combined aerobic exercise and resistance training program (EXT) for eight weeks. Prior to and following the EXT, patient-reported fatigue (FACIT-F), quality of life (FACT-BMT), cardiorespiratory fitness (peak oxygen uptake, [VO2peak], peak power output, [watts]) were assessed. Patient satisfaction was also assessed at eight weeks. 

Results

Of 13 patients recruited, 9/11 participants have completed the study. Attendance to the EXT was >80%. Compared with baseline values, EXT significantly improved fatigue (FACIT-F absolute change +16.8 points, p=0.03, Cohen’s d=0.89), QoL (FACT-BMT absolute change  +12 points, p=0.03, d=0.83) and peak power output (absolute change, +13.12 watts, p=0.04, d=0.85). Despite no differences detected for VO2peak ml/kg/min, medium effect estimates were observed between baseline and eight weeks (d=0.67-0.76). Satisfaction was high, 9/9 (100%) reported they would recommend the program to others and reported further benefits including mood improvement, and improved capacity for daily activities. There were no adverse events. 

Conclusions

In a small sample of participants with fatigue >6 months after alloHSCT, EXT improved fatigue and QoL after eight-weeks. While these pilot results appear promising, future randomised controlled trials are required to better understand the impact of EXT on participants with fatigue 6 months after alloHSCT.