e-Article
Cardiopulmonary performance in allogeneic hematopoietic cell transplantation recipients-evaluation of pre-transplant risk assessments.
Document Type
Academic Journal
Author
Pahl A; Department of Medicine I, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany. antonia.pahl@uniklinik-freiburg.de.; Waibel S; Department of Neurology and Neuroscience, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.; Wehrle A; Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany.; Ihorst G; Clinical Trials Unit, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.; Gollhofer A; Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany.; Bertz H; Department of Medicine I, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
Source
Publisher: Nature Publishing Group Country of Publication: England NLM ID: 8702459 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1476-5365 (Electronic) Linking ISSN: 02683369 NLM ISO Abbreviation: Bone Marrow Transplant Subsets: MEDLINE
Subject
Language
English
Abstract
Cardiopulmonary performance reflects how well different organ systems interact. It is inter alia influenced by body composition, determines patients' quality of life and can also predict mortality. However, it is not yet used for risk prediction prior to allogeneic hematopoietic cell transplantations (alloHCT). Thus, we aimed to examine the predictive power of peak oxygen consumption (VO2peak) as a representative of cardiopulmonary performance and that of body composition before alloHCT to determine overall survival (OS) and non-relapse mortality (NRM) 2 years after transplantation. We also compared it with the predictive power of four commonly-used risk scores: revised Pretransplant Assessment of Mortality (rPAM), Hematopoietic Cell Transplantation-specific Comorbidity Index (HCT-CI), revised Disease Risk Index (rDRI), European Society for Blood and Marrow Transplantation (EBMT). Fifty-nine patients performed a cardiopulmonary exercise test and body composition assessments before alloHCT and were observed for 2 years. Sixteen patients died. VO2peak and most risk scores assessed pre-transplant revealed no association with OS or NRM. Body composition parameters only within univariable analyses. But higher rDRI and the male sex, were associated with shorter OS and higher NRM. We thus propose that the current risk assessments be reconsidered. The predictive value of VO2peak and body composition need further clarification, however.