Physical exercise in patients treated with hematopoietic stem cell transplantation

Hematopoietic stem cell transplantation (HSCT) is currently the treatment of choice for many hematologic malignancies. The aim of HSCT is usually to cure, or in some malignancies, to improve survival. Two frequently applied types of HSCT can be distinguished: autologous stem cell transplantation (auto-SCT), which uses the patient’s own stem cells, and allogeneic stem cell transplantation (allo-SCT), which uses the stem cells of a donor. Unfortunately, both auto- and allo-SCT are aggressive treatment options which are associated with short- and long-term medical complications. HSCT survivors may also report physical and psychological symptoms and deficits in quality of life. This thesis focuses on the rehabilitation of patients recently treated with HSCT, and in particular on the effectiveness of exercise interventions. The five specific aims are: 1) to quantify health-related physical fitness in patients recently treated with auto-SCT, and to determine its demographic and clinical correlates; 2) to systematically review the literature on the effectiveness of exercise interventions in comparison to usual care with respect to physical fitness, fatigue and health-related quality of life in patients treated with HSCT; 3) to determine the effectiveness of a high intensity exercise program on physical fitness and fatigue in patients recently treated with auto-SCT (EXIST study); 4) to evaluate the actual implementation of this exercise program; and 5) to explore the experiences with return to work among HSCT survivors.