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Post-Transplant Events

Individualized exercise program for the treatment of severe fatigue in patients after allogeneic hematopoietic stem-cell transplant: a pilot study

Bone Marrow Transplantation volume 37, pages 945–954 (2006)Cite this article

Abstract

Chronic cancer-related fatigue in otherwise asymptomatic post-allogeneic hematopoietic stem cell transplant (HSCT) patients is common and debilitating. This pilot study investigated whether patients with no clinical or psychological abnormalities but severe fatigue would respond to an individually adapted aerobic exercise program. Participants were 12 patients (eight male, and four female patients), median age 47 years and 41 months post-HSCT with a variety of hematopoetic cancer diagnoses. All underwent a 12-week individualized mild aerobic exercise program, preceded by a 4-week introduction and baseline testing phase. Psychological measures included fatigue, mood and depression. Exercise-related physiological outcomes included power output at ventilatory threshold 2 (VT2) and associated changes in stroke volume, heart rate, blood lactate concentration and ratings of perceived exertion. Patients were assessed for fatigue before, immediately after and at 3, 6, 9 and 12 months post-program. Significant improvements were found on both measures of fatigue (both P<0.001), with a very large effect size of 1.82 on the The Functional Assessment of Cancer Therapy – Fatigue Module, which were maintained over the follow-up period. Exercise testing revealed a mean increase (P<0.001) of 28% in power output at VT2 with an increase (P<0.001) in stroke volume and a decrease (P<0.001) in heart rate, blood lactate and perceived exertion at pre-intervention VT2 power output.

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Acknowledgements

This study has been generously funded by the Community Opportunity Foundation of Alberta (COFA). We thank Eric Hobson and Robert McKenzie, the foundation's directors and co-founders. Heart Rate Monitors for each participant to keep were supplied by Polar Electro Canada. Mr Alan Hobson has been instrumental in this study, spearheading it based on his own experience as an HSCT survivor. He has served as motivator and consultant throughout the study, both for the study team and the participants. In addition, Mr Cal Zaryski of criticalspeed.com was an additional consultant on matters of physical training. Technical support was provided by Maura Hooper, Kelly Quipp, Rosie Neil, Heather Philpot, Justin Seguin, Gwen Butterfield and Natalie Galloway. Dr Linda Carlson is supported by a Canadian Institutes of Health Research New Investigator Award. Finally, we thank all the survivors who were willing to invest their valuable time and energy into this protocol. They continue to inspire us and other survivors in their cancer journeys.

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Authors and Affiliations

  1. Tom Baker Cancer Centre, Alberta Cancer Board, Calgary, Alberta, Canada

    L E Carlson, J Russell & T Whittaker

  2. Department of Oncology, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada

    L E Carlson & J Russell

  3. Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada

    D Smith

  4. University of Saskatchewan, Saskatoon, Saskatchewan, Canada

    C Fibich

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  1. L E Carlson
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Correspondence to L E Carlson.

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Carlson, L., Smith, D., Russell, J. et al. Individualized exercise program for the treatment of severe fatigue in patients after allogeneic hematopoietic stem-cell transplant: a pilot study. Bone Marrow Transplant 37, 945–954 (2006). https://doi.org/10.1038/sj.bmt.1705343

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