TY - JOUR
T1 - Negative impact of chronic graft-versus-host disease and glucocorticoid on the recovery of physical function after allogeneic hematopoietic stem cell transplantation
AU - Hayakawa, Jin
AU - Miyamura, Daijiro
AU - Kimura, Shun ichi
AU - Gomyo, Ayumi
AU - Tamaki, Masaharu
AU - Akahoshi, Yu
AU - Harada, Naonori
AU - Ugai, Tomotaka
AU - Kusuda, Machiko
AU - Kameda, Kazuaki
AU - Wada, Hidenori
AU - Ishihara, Yuko
AU - Kawamura, Koji
AU - Sakamoto, Kana
AU - Sato, Miki
AU - Terasako-Saito, Kiriko
AU - Kikuchi, Misato
AU - Nakasone, Hideki
AU - Kako, Shinichi
AU - Kanda, Yoshinobu
N1 - Publisher Copyright:
© 2018, Springer Nature Limited.
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Quality of life of patients who undergo allogeneic hematopoietic stem cell transplantation (HSCT) temporally deteriorates and recovers over several years. We retrospectively evaluate the impact of chronic graft-versus-host disease (GVHD) and glucocorticoid on physical recovery. We included 162 patients who underwent their first allogeneic HSCT between October 2010 and December 2015 in a single hospital. All patients are planned to undergo physical function tests before and 1, 3, 12 months after allogeneic HSCT. Scores of knee extension strength and distance covered in the 6-min walk test (6MWT) recovered at the 12-month assessment. Both chronic GVHD and high dose glucocorticoid were associated with delayed recovery of body mass index (BMI), hand grip strength, knee extension strength, and duration of standing on one foot. Lung GVHD and high dose glucocorticoid had negative impact on the distance covered in the 6MWT. A multivariate analysis revealed that chronic GVHD and glucocorticoid was an independent risk factor for decreased BMI and delayed recovery of muscle strength, respectively. Our results suggest that high-risk patients who have chronic GVHD or who receive glucocorticoid therapy may require reduced dose of glucocorticoid and long-term physical support to recover physical function after transplantation.
AB - Quality of life of patients who undergo allogeneic hematopoietic stem cell transplantation (HSCT) temporally deteriorates and recovers over several years. We retrospectively evaluate the impact of chronic graft-versus-host disease (GVHD) and glucocorticoid on physical recovery. We included 162 patients who underwent their first allogeneic HSCT between October 2010 and December 2015 in a single hospital. All patients are planned to undergo physical function tests before and 1, 3, 12 months after allogeneic HSCT. Scores of knee extension strength and distance covered in the 6-min walk test (6MWT) recovered at the 12-month assessment. Both chronic GVHD and high dose glucocorticoid were associated with delayed recovery of body mass index (BMI), hand grip strength, knee extension strength, and duration of standing on one foot. Lung GVHD and high dose glucocorticoid had negative impact on the distance covered in the 6MWT. A multivariate analysis revealed that chronic GVHD and glucocorticoid was an independent risk factor for decreased BMI and delayed recovery of muscle strength, respectively. Our results suggest that high-risk patients who have chronic GVHD or who receive glucocorticoid therapy may require reduced dose of glucocorticoid and long-term physical support to recover physical function after transplantation.
UR - https://www.scopus.com/pages/publications/85055246505
U2 - 10.1038/s41409-018-0365-4
DO - 10.1038/s41409-018-0365-4
M3 - Article
C2 - 30337699
AN - SCOPUS:85055246505
SN - 0268-3369
VL - 54
SP - 994
EP - 1003
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 7
ER -