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Waked IS, Ibrahim ZM, Alkhamees N, Rashad AH. Effects of pre-transplant chest physical therapy on spirometric values and respiratory muscle strength in patients waiting for allogeneic hematopoietic stem cell transplantation: a randomized controlled trial. Arch Med Sci 2022; 20:104-112. [PMID: 38414465 PMCID: PMC10895947 DOI: 10.5114/aoms/150780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 06/08/2022] [Indexed: 02/29/2024] Open
Abstract
Introduction Many noninfectious pulmonary complications occur immediately within the first few weeks after allogeneic hematopoietic stem cell transplantation (allo-HSCT). This study aimed to evaluate the efficacy of chest physical therapy (CPT) performed during the pre-transplant period in terms of spirometric values and respiratory muscle strength (RMS) in patients waiting for allo-HSCT. Material and methods Fifty patients aged 40 to 55 years who were scheduled for allo-HSCT were randomly allocated into two equal-sized groups, a CPT group and a control group. The CPT group (n = 25) received CPT in addition to routine medical treatment, while the control group (n = 25) received routine medical treatment only. Patients in both groups received standard physical therapy during the inpatient waiting period. Interventions were conducted daily for 3 weeks before allo-HSCT. Pulmonary function (FEV1, FVC, and FEV1/FVC) was measured by spirometry, and RMS was measured by a respiratory pressure meter. A baseline assessment was done 3 weeks before allo-HSCT (T0), then at the end of treatment immediately before allo-HSCT (T1) and the last assessment at 3 weeks after allo-HSCT (T2) for all measured variables. Results In comparing the two groups at T1 and T2, the mean spirometric values and RMS, maximal inspiratory pressure, and maximal expiratory pressure were all improved significantly in the CPT group in comparison with the control group (p < 0.05). Conclusions Adding a 3-week CPT intervention to the pre-transplant rehabilitation program seems to be effective and safe for allo-HSCT recipients, as it improves pre-transplant pulmonary function and respiratory muscle strength and prevents their post-transplant decrease.
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Affiliation(s)
- Intsar S Waked
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Egypt
| | - Zizi M Ibrahim
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Nouf Alkhamees
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Ahmed H Rashad
- Clinical Oncology Department, Cairo University, Cairo, Egypt
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Elsawy M, Storer BE, Milano F, Sandmaier BM, Delaney C, Salit RB, Rashad AH, Woolfrey AE, Appelbaum FR, Storb R, Sorror ML. Prognostic Performance of the Augmented Hematopoietic Cell Transplantation-Specific Comorbidity/Age Index in Recipients of Allogeneic Hematopoietic Stem Cell Transplantation from Alternative Graft Sources. Biol Blood Marrow Transplant 2018; 25:1045-1052. [PMID: 30500442 DOI: 10.1016/j.bbmt.2018.11.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 11/25/2018] [Indexed: 01/11/2023]
Abstract
The Hematopoietic Cell Transplantation-Specific Comorbidity Index (HCT-CI) was developed and validated to weigh the burden of pretransplantation comorbidities and estimate their impact on post-transplantation risks of nonrelapse mortality (NRM). Recently, the HCT-CI was augmented by the addition of both age and the values of 3 markers: ferritin, albumin, and platelet count. So far, research involving The HCT-CI has been limited almost exclusively to recipients of allogeneic hematopoietic cell transplantation (HCT) from HLA-matched grafts. To this end, we sought to investigate the discriminative capacity of an augmented comorbidity/age index among 724 recipients of allogeneic HCT from HLA-mismatched (n = 345), haploidentical (n = 117), and umbilical cord blood (UCB; n = 262) grafts between 2000 and 2013. In the overall cohort, the augmented comorbidity/age index had a higher c-statistic estimate for prediction of NRM compared with the original HCT-CI (.63 versus .59). Findings were similar for recipients of HLA-mismatched (.62 versus .59), haploidentical (.60 versus .54), or UCB grafts (.65 versus .61). Compared with patients with an HCT-CI score ≥4, those with a score <4 had a higher survival rate among recipients of HLA-mismatched (55% versus 39%; P < .0008), HLA-haploidentical (58% versus 38%; P = .01), or UCB (67% versus 48%; P = .004) grafts. Our results demonstrate the utility of the augmented comorbidity/age index as a valid prognostic tool among recipients of allogeneic HCT from alternative graft sources.
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Affiliation(s)
- Mahmoud Elsawy
- Clinical Research Division, Fred Hutchinson Cancer Research Center; Seattle, Washington; Division of Hematology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Barry E Storer
- Clinical Research Division, Fred Hutchinson Cancer Research Center; Seattle, Washington; Department of Biostatistics, University of Washington School of Public Health, Seattle, Washington
| | - Filippo Milano
- Clinical Research Division, Fred Hutchinson Cancer Research Center; Seattle, Washington; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine; Seattle, Washington
| | - Brenda M Sandmaier
- Clinical Research Division, Fred Hutchinson Cancer Research Center; Seattle, Washington; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine; Seattle, Washington
| | - Colleen Delaney
- Clinical Research Division, Fred Hutchinson Cancer Research Center; Seattle, Washington; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine; Seattle, Washington
| | - Rachel B Salit
- Clinical Research Division, Fred Hutchinson Cancer Research Center; Seattle, Washington; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine; Seattle, Washington
| | | | - Ann E Woolfrey
- Clinical Research Division, Fred Hutchinson Cancer Research Center; Seattle, Washington; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine; Seattle, Washington
| | - Frederick R Appelbaum
- Clinical Research Division, Fred Hutchinson Cancer Research Center; Seattle, Washington; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine; Seattle, Washington
| | - Rainer Storb
- Clinical Research Division, Fred Hutchinson Cancer Research Center; Seattle, Washington; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine; Seattle, Washington
| | - Mohamed L Sorror
- Clinical Research Division, Fred Hutchinson Cancer Research Center; Seattle, Washington; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine; Seattle, Washington.
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