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Nikitin et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 9
doi: 10.3205/ctt-2010-No9-abstract27
© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "4th Raisa Gorbacheva Memorial Meeting on Hematopoietic Stem Cell Transplantation",
Saint Petersburg, Russia, September 18–20, 2010

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Exercise intervention in pediatric patients receiving high-dose chemotherapy with autologous hematopoietic stem cell transplantation

Ilya A. Nikitin, Ilya V. Kazantsev, Anastasia Yu. Zinchenko, Inna V. Markova, Elena V. Mozova, Lyudmila S. Zubarovskaya, Boris V. Afanasyev

R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, Pavlov State Medical University, Saint-Petersburg, Russia

Correspondence: Ilya A.Nikitin, R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, Saint-Petersburg Pavlov State Medical University, 6/8, Tolstoy str., Saint-Petersburg, 197022, Russia, E-mail: Iliya_Nikitin@spam is badyahoo.com

Abstract

Introduction. Physical exercise is successfully used in adult patients undergoing high-dose chemotherapy (HDCT) with autologous hematopoietic stem cell transplantation (auto-HSCT), speeding up hematological recovery and reducing the inpatient period. This method has not been tested in pediatric auto-HSCT recipients.

Patients and methods. From March 2008 until April 2010 17 children with solid tumors undergoing HDCT with auto-SCT were exposed to individually devised physical therapy programs. Specific exercises were adjusted according to the patients’ current physical status from admission until their discharge. The control group consisted of 11 patients receiving no physical therapy. The median age for both groups was 12 years. The following conditioning regimens were used in both groups: busulfan 16 mg/kg and melphalan 140 mg/m2, melphalan 140 mg/m2, and BEAM. Both groups had similar clinical characteristics with statistically non-significant differences.

Results. The median time to ANC recovery was 16 (12–32) months in the exercise group and 20 (14–29) in the control group respectively (p=0.04). The median PLT recovery was also faster in the exercise group (22 vs. 27 days, p=0.16). And the median number of red cell transfusions was 3 in the exercise group and 8 in the control group (p=0.02). Physical therapy was not associated with hemorrhagic complications.

Conclusions. We justified the feasibility of physical exercise in auto-HSCT in pediatric patients receiving HDCT with auto-SCT starting from the conditioning period and continuing throughout the recovery period. Furthermore, the physical exercise group was characterized by earlier hematologic recovery, allowing a shorter hospital stay and decreased transfusion dependency.

Keywords: physical exercise, high-dose chemotherapy, autologous hematopoietic stem cell transplantation

 

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