Assessing the Effect of Autologous Hematopoietic Stem Cell Transplant on Physical Function, Peripheral Neuropathy and Balance

Research

Objectives: To evaluate the impact of autologous hematopoietic stem cell transplant (Auto HSCT) on physical function, chemotherapy-induced peripheral neuropathy (CIPN) and balance.

Design: Patients admitted for Auto HSCT completed a Five Times Sit to Stand (FTSTS), Six Minute Walk Test (6MWT), 10 Meter Walk Test (10-mwt) and the Activity Measure of Post-Acute Care Inpatient Basic Mobility Short Form (AM-PAC) as part of standard physical therapy evaluation prior to receiving Auto HSCT. Patients also completed the Modified Clinical Test of Sensory Interaction in Balance (mCTSIB) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-CIPN twenty-item scale (EORTC CIPN-20) to assess balance and peripheral neuropathy. All outcome measures were repeated 0-3 days prior to discharge.

Setting: The study was conducted in an acute care oncology setting.

Participants: 30 participants who underwent inpatient Auto HSCT.

Interventions: The study followed an observational design with standard of care interventions delivered based on impairments identified at the time of physical therapy evaluation.

Outcome Measures: FTSTS, 6MWT, 10-mwt, AM-PAC, EORTC CIPN-20, and mCTSIB

Results: Patients under the age of 60 had a significant increase in FTSTS from 11.29 seconds (s) to 14.2 s and a decrease in 6MWT distance from 428.3 meters (m) to 392.13 m at discharge, indicating a decline in physical function. Patients age 60 and above demonstrated a decrease in 6MWT score from 362.01 s to 314.4 s placing the average 6MWT below 400 m, which suggests an increased risk of mortality. Furthermore, a FTSTS score of >13 s was observed for all age groups, indicating balance deficits. Utilizing a two-tailed paired t-test to evaluate the Five Times Sit to Stand test (FTSTS) results among patients under 60 years of age, statistical analysis revealed a p-value of 0.02, signifying a notable decrease in both strength and balance. Furthermore, patients age 60 years and over demonstrated a p-value of 0.02 for the Six Minute Walk Test (6MWT), denoting a substantial decline in endurance upon discharge. No significant changes were observed in AM-PAC scores or 10-mwt, and there was no increase in acute neuropathy or balance deficits between age groups on the EORTC CIPN-20 or mCTSIB.

Conclusions: Patients who underwent Auto HSCT had decreased strength and endurance at the time of hospital admission and experienced further decline upon discharge. However, no significant balance deficits or CIPN were observed immediately after transplant.

Author(s) Disclosures: The authors declare no conflicts of interest.