Physical Exercise Training versus Relaxation in Allogeneic stem cell transplantation (PETRA Study) - Rationale and design of a randomized trial to evaluate a yearlong exercise intervention on overall survival and side-effects after allogeneic stem cell transplantation

Joachim Wiskemann, Rea Kuehl, Peter Dreger, Gerhard Huber, Nikolaus Kleindienst, Cornelia M Ulrich, Martin Bohus, Joachim Wiskemann, Rea Kuehl, Peter Dreger, Gerhard Huber, Nikolaus Kleindienst, Cornelia M Ulrich, Martin Bohus

Abstract

Background: Allogeneic stem cell transplantation (allo-HCT) is associated with high treatment-related mortality and innumerable physical and psychosocial complications and side-effects, such as high fatigue levels, loss of physical performance, infections, graft-versus-host disease (GvHD) and distress. This leads to a reduced quality of life, not only during and after transplantation, but also in the long term. Exercise interventions have been shown to be beneficial in allo-HCT patients. However, to date, no study has focused on long-term effects and survival. Previous exercise studies used 'usual care' control groups, leaving it unclear to what extent the observed effects are based on the physical effects of exercise itself, or rather on psychosocial factors such as personal attention. Furthermore, effects of exercise on and severity of GvHD have not been examined so far. We therefore aim to investigate the effects and biological mechanisms of exercise on side-effects, complications and survival in allo-HCT patients during and after transplantation.

Methods/design: The PETRA study is a randomized, controlled intervention trial investigating the effects of a yearlong partly supervised mixed exercise intervention (endurance and resistance exercises, 3-5 times per week) in 256 patients during and after allogeneic stem cell transplantation. Patients in the control group perform progressive muscle relaxation training (Jacobsen method) with the same frequency. Main inclusion criterion is planned allo-HCT. Main exclusion criteria are increased fracture risk, no walking capability or severe cardiorespiratory problems. Primary endpoint is overall survival after two years; secondary endpoints are non-relapse mortality, median survival, patient reported outcomes including cancer related fatigue and quality of life, physical performance, body composition, haematological/immunological reconstitution, inflammatory parameters, severity of complications and side-effects (e.g. GvHD and infections), and cognitive capacity.

Discussion: The PETRA study will contribute to a better understanding of the physiological and psychological effects of exercise training and their biological mechanisms in cancer patients after allo-HCT. The ultimate goal is the implementation of optimized intervention programs to reduce side-effects and improve quality of life and potentially prognosis after allogeneic stem cell transplantation.

Trial registration: ClinicalTrials.gov Identifier: NCT01374399 .

Figures

Fig. 1
Fig. 1
CONSORT: Study Flow of the PETRA study

References

    1. Copelan EA. Hematopoietic stem-cell transplantation. N Engl J Med. 2006;354(17):1813–26. doi: 10.1056/NEJMra052638.
    1. Cramp F, Byron-Daniel J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev. 2012;11
    1. Knols R, Aaronson NK, Uebelhart D, Fransen J, Aufdemkampe G. Physical exercise in cancer patients during and after medical treatment: a systematic review of randomized and controlled clinical trials. J Clin Oncol. 2005;23(16):3830–42. doi: 10.1200/JCO.2005.02.148.
    1. Spence RR, Heesch KC, Brown WJ. Exercise and cancer rehabilitation: a systematic review. Cancer Treat Rev. 2010;36(2):185–94. doi: 10.1016/j.ctrv.2009.11.003.
    1. Speck RM, Courneya KS, Masse LC, Duval S, Schmitz KH. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2010;4(2):87–100. doi: 10.1007/s11764-009-0110-5.
    1. Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvao DA, Pinto BM, et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010;42(7):1409–26. doi: 10.1249/MSS.0b013e3181e0c112.
    1. Wiskemann J, Huber G. Physical exercise as adjuvant therapy for patients undergoing hematopoietic stem cell transplantation. Bone Marrow Transplant. 2008;41(4):321–9. doi: 10.1038/sj.bmt.1705917.
    1. Coleman EA, Coon SK, Kennedy RL, Lockhart KD, Stewart CB, Anaissie EJ, et al. Effects of exercise in combination with epoetin alfa during high-dose chemotherapy and autologous peripheral blood stem cell transplantation for multiple myeloma. Oncol Nurs Forum. 2008;35(3):E53–61. doi: 10.1188/08.ONF.E53-E61.
    1. Shelton ML, Lee JQ, Morris GS, Massey PR, Kendall DG, Munsell MF, et al. A randomized control trial of a supervised versus a self-directed exercise program for allogeneic stem cell transplant patients. Psychooncology. 2008;18(4):353–9. doi: 10.1002/pon.1505.
    1. Jarden M, Baadsgaard MT, Hovgaard DJ, Boesen E, Adamsen L. A randomized trial on the effect of a multimodal intervention on physical capacity, functional performance and quality of life in adult patients undergoing allogeneic SCT. Bone Marrow Transplant. 2009;43(9):725–37. doi: 10.1038/bmt.2009.27.
    1. Hacker ED, Larson J, Kujath A, Peace D, Rondelli D, Gaston L. Strength training following hematopoietic stem cell transplantation. Cancer Nurs. 2011;34(3):238–49. doi: 10.1097/NCC.0b013e3181fb3686.
    1. Knols RH, de Bruin ED, Shirato K, Uebelhart D, Aaronson NK. Physical activity interventions to improve daily walking activity in cancer survivors. BMC Cancer. 2010;10:406. doi: 10.1186/1471-2407-10-406.
    1. Wiskemann J, Dreger P, Schwerdtfeger R, Bondong A, Huber G, Kleindienst N, et al. Effects of a partly self-administered exercise program before, during, and after allogeneic stem cell transplantation. Blood. 2011;117(9):2604–13. doi: 10.1182/blood-2010-09-306308.
    1. Persoon S, Kersten MJ, van der Weiden K, Buffart LM, Nollet F, Brug J, et al. Effects of exercise in patients treated with stem cell transplantation for a hematologic malignancy: a systematic review and meta-analysis. Cancer Treat Rev. 2013;39(6):682–90. doi: 10.1016/j.ctrv.2013.01.001.
    1. Morishita S, Kaida K, Ikegame K, Yoshihara S, Taniguchi K, Okada M, et al. Impaired physiological function and health-related QOL in patients before hematopoietic stem-cell transplantation. Support Care Cancer. 2012;20(4):821–9. doi: 10.1007/s00520-011-1156-2.
    1. White AC, Terrin N, Miller KB, Ryan HF. Impaired respiratory and skeletal muscle strength in patients prior to hematopoietic stem-cell transplantation. Chest. 2005;128(1):145–52. doi: 10.1378/chest.128.1.145.
    1. Lakoski SG, Eves ND, Douglas PS, Jones LW. Exercise rehabilitation in patients with cancer. Nat Rev Clin Oncol. 2012;9(5):288–96. doi: 10.1038/nrclinonc.2012.27.
    1. Bellizzi KM, Rowland JH, Arora NK, Hamilton AS, Miller MF, Aziz NM. Physical activity and quality of life in adult survivors of non-Hodgkin’s lymphoma. J Clin Oncol. 2009;27(6):960–6. doi: 10.1200/JCO.2008.17.5026.
    1. Andrykowski MA, Bishop MM, Hahn EA, Cella DF, Beaumont JL, Brady MJ, et al. Long-term health-related quality of life, growth, and spiritual well-being after hematopoietic stem-cell transplantation. J Clin Oncol. 2005;23(3):599–608. doi: 10.1200/JCO.2005.03.189.
    1. Ferrara JL, Levine JE, Reddy P, Holler E. Graft-versus-host disease. Lancet. 2009;373(9674):1550–61. doi: 10.1016/S0140-6736(09)60237-3.
    1. Mitchell SA, Leidy NK, Mooney KH, Dudley WN, Beck SL, LaStayo PC, et al. Determinants of functional performance in long-term survivors of allogeneic hematopoietic stem cell transplantation with chronic graft-versus-host disease (cGVHD) Bone Marrow Transplant. 2010;45(4):762–9. doi: 10.1038/bmt.2009.238.
    1. Mosher CE, Redd WH, Rini CM, Burkhalter JE, DuHamel KN. Physical, psychological, and social sequelae following hematopoietic stem cell transplantation: a review of the literature. Psychooncology. 2009;18(2):113–27. doi: 10.1002/pon.1399.
    1. Tichelli, A., A. Rovo, and A. Gratwohl. Late pulmonary, cardiovascular, and renal complications after hematopoietic stem cell transplantation and recommended screening practices. Hematology Am Soc Hematol Educ Program 2008: p. 125–33, doi: 10.1182/asheducation-2008.1.125.
    1. Baker KS, Armenian S, Bhatia S. Long-term consequences of hematopoietic stem cell transplantation: current state of the science. Biol Blood Marrow Transplant. 2010;16(1 Suppl):S90–6. doi: 10.1016/j.bbmt.2009.09.017.
    1. NCCN Clinical Practice Guidelines in Oncology. Cancer-Related Fatigue. 2015 [cited 2015 03.01.]; Available from: .
    1. Bevans MF, Mitchell SA, Marden S. The symptom experience in the first 100 days following allogeneic hematopoietic stem cell transplantation (HSCT) Support Care Cancer. 2008;16(11):1243–54. doi: 10.1007/s00520-008-0420-6.
    1. Al-Majid S, Gray DP. A biobehavioral model for the study of exercise interventions in cancer-related fatigue. Biol Res Nurs. 2009;10(4):381–91. doi: 10.1177/1099800408324431.
    1. Ryan JL, Carroll JK, Ryan EP, Mustian KM, Fiscella K, Morrow GR. Mechanisms of cancer-related fatigue. Oncologist. 2007;12(Suppl 1):22–34. doi: 10.1634/theoncologist.12-S1-22.
    1. Bergenthal N, Will A, Streckmann F, Wolkewitz KD, Monsef I, Engert A, et al. Aerobic physical exercise for adult patients with haematological malignancies. Cochrane Database Syst Rev. 2014;11
    1. Ballard-Barbash R, Friedenreich CM, Courneya KS, Siddiqi SM, McTiernan A, Alfano CM. Physical activity, biomarkers, and disease outcomes in cancer survivors: a systematic review. J Natl Cancer Inst. 2012;104(11):815–40. doi: 10.1093/jnci/djs207.
    1. Jones LW, Watson D, Herndon JE, 2nd, Eves ND, Haithcock BE, Loewen G, et al. Peak oxygen consumption and long-term all-cause mortality in nonsmall cell lung cancer. Cancer. 2010;116(20):4825–32. doi: 10.1002/cncr.25396.
    1. Courneya KS, Segal RJ, McKenzie DC, Dong H, Gelmon K, Friedenreich CM, et al. Effects of exercise during adjuvant chemotherapy on breast cancer outcomes. Med Sci Sports Exerc. 2014;46(9):1744–51. doi: 10.1249/MSS.0000000000000297.
    1. Wood WA, Deal AM, Reeve BB, Abernethy AP, Basch E, Mitchell SA, et al. Cardiopulmonary fitness in patients undergoing hematopoietic SCT: a pilot study. Bone Marrow Transplant. 2013;48(10):1342–9. doi: 10.1038/bmt.2013.58.
    1. Guilfoyle R, Demers A, Bredeson C, Richardson E, Rubinger M, Szwajcer D, et al. Performance status, but not the hematopoietic cell transplantation comorbidity index (HCT-CI), predicts mortality at a Canadian transplant center. Bone Marrow Transplant. 2009;43(2):133–9. doi: 10.1038/bmt.2008.300.
    1. Wiskemann, J., N. Kleindienst, R. Kuehl, P. Dreger, R. Schwerdtfeger, M. Bohus. Effects of physical exercise on survival after allogeneic stem cell transplantation. Int J Cancer 2015, doi: 10.1002/ijc.29633. [Epub ahead of print].
    1. Drouin JM, Valovich-mcLeod TC, Shultz SJ, Gansneder BM, Perrin DH. Reliability and validity of the Biodex system 3 pro isokinetic dynamometer velocity, torque and position measurements. Eur J Appl Physiol. 2004;91(1):22–9. doi: 10.1007/s00421-003-0933-0.
    1. Eitzen I, Hakestad KA, Risberg MA. Inter- and intrarater reliability of isokinetic thigh muscle strength tests in postmenopausal women with osteopenia. Arch Phys Med Rehabil. 2012;93(3):420–7. doi: 10.1016/j.apmr.2011.10.001.
    1. Webber SC, Porter MM. Reliability of ankle isometric, isotonic, and isokinetic strength and power testing in older women. Phys Ther. 2010;90(8):1165–75. doi: 10.2522/ptj.20090394.
    1. Bohannon RW. Reference values for extremity muscle strength obtained by hand-held dynamometry from adults aged 20 to 79 years. Arch Phys Med Rehabil. 1997;78(1):26–32. doi: 10.1016/S0003-9993(97)90005-8.
    1. Knols RH, de Bruin ED, Uebelhart D, Aufdemkampe G, Schanz U, Stenner-Liewen F, et al. Effects of an outpatient physical exercise program on hematopoietic stem-cell transplantation recipients: a randomized clinical trial. Bone Marrow Transplant. 2011;46(9):1245–55. doi: 10.1038/bmt.2010.288.
    1. Mello M, Tanaka C, Dulley FL. Effects of an exercise program on muscle performance in patients undergoing allogeneic bone marrow transplantation. Bone Marrow Transplant. 2003;32(7):723–8. doi: 10.1038/sj.bmt.1704227.
    1. Jones LW, Eves ND, Haykowsky M, Joy AA, Douglas PS. Cardiorespiratory exercise testing in clinical oncology research: systematic review and practice recommendations. Lancet Oncol. 2008;9(8):757–65. doi: 10.1016/S1470-2045(08)70195-5.
    1. Steins Bisschop CN, Velthuis MJ, Wittink H, Kuiper K, Takken T, van der Meulen WJ, et al. Cardiopulmonary exercise testing in cancer rehabilitation: a systematic review. Sports Med. 2012;42(5):367–79. doi: 10.2165/11598480-000000000-00000.
    1. Kelsey CR, Scott JM, Lane A, Schwitzer E, West MJ, Thomas S, et al. Cardiopulmonary exercise testing prior to myeloablative allo-SCT: a feasibility study. Bone Marrow Transplant. 2014;49(10):1330–6. doi: 10.1038/bmt.2014.159.
    1. Crapo R, Casaburi R, Coaties A, Enright P, MacIntyre N, McKay P, et al. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166(1):111–7. doi: 10.1164/ajrccm.166.1.at1102.
    1. Enright PL, Sherrill DL. Reference equations for the six-minute walk in healthy adults. Am J Respir Crit Care Med. 1998;158(5 Pt 1):1384–7. doi: 10.1164/ajrccm.158.5.9710086.
    1. Valentinuzzi ME. Bioelectrical impedance techniques in medicine. Part I: bioimpedance measurement. First section: general concepts. Crit Rev Biomed Eng. 1996;24(4–6):223–55.
    1. Segal KR, Burastero S, Chun A, Coronel P, Pierson RN, Jr, Wang J. Estimation of extracellular and total body water by multiple-frequency bioelectrical-impedance measurement. Am J Clin Nutr. 1991;54(1):26–9.
    1. Butte NF, Ekelund U, Westerterp KR. Assessing physical activity using wearable monitors: measures of physical activity. Med Sci Sports Exerc. 2012;44(1 Suppl 1):S5–S12. doi: 10.1249/MSS.0b013e3182399c0e.
    1. Hacker E, Ferrans C, Verlen E, Ravandi F, Besien K, Gelms J, et al. Farigue and physival aktivity in patients undergoing hematopoietic stem cell transplant. Oncol Nurs Forum. 2006;33(3):614–624. doi: 10.1188/06.ONF.614-624.
    1. Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A. The european organization for research and treatment of cancer QLQ-C30: a quality-of-life instrument for Use in international clinical trials in oncology. J Natl Cancer Inst. 1993;8:365–376. doi: 10.1093/jnci/85.5.365.
    1. Velikova G, Weis J, Hjermstad MJ, Kopp M, Morris P, Watson M, et al. The EORTC QLQ-HDC29: a supplementary module assessing the quality of life during and after high-dose chemotherapy and stem cell transplantation. Eur J Cancer. 2007;43(1):87–94. doi: 10.1016/j.ejca.2006.09.004.
    1. Grulke N, Albani C, Bailer H. Quality of life in patients before and after haematopoietic stem cell transplantation measured with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire QLQ-C30. Bone Marrow Transplant. 2012;47(4):473–82. doi: 10.1038/bmt.2011.107.
    1. Schwarz R, Hinz A. Reference data for the quality of life questionnaire EORTC QLQ-C30 in the general German population. Eur J Cancer. 2001;37(11):1345–51. doi: 10.1016/S0959-8049(00)00447-0.
    1. Cocks K, King MT, Velikova G, Martyn St-James M, Fayers PM, Brown JM. Evidence-based guidelines for determination of sample size and interpretation of the European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30. J Clin Oncol. 2011;29(1):89–96. doi: 10.1200/JCO.2010.28.0107.
    1. Smets EM, Garssen B, Bonke B, De Haes JC. The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue. J Psychosom Res. 1995;39(3):315–25. doi: 10.1016/0022-3999(94)00125-O.
    1. Schwarz R, Krauss O, Hinz A. Fatigue in the general population. Onkologie. 2003;26(2):140–4.
    1. Bower JE, Bak K, Berger A, Breitbart W, Escalante CP, Ganz PA, et al. Screening, assessment, and management of fatigue in adult survivors of cancer: an American Society of Clinical oncology clinical practice guideline adaptation. J Clin Oncol. 2014;32(17):1840–50. doi: 10.1200/JCO.2013.53.4495.
    1. National Comprehensive Cancer Distress management. Clinical practice guidelines. J Natl Compr Canc Netw. 2003;1(3):344–74.
    1. Mehnert A, Mueller D, Lehmann C, Koch U. The German version of the NCCN distress thermometer: validation of a screening instrument for assessment of psychosocial distress in cancer patients. Zeitschrift für Psychiatrie und Psychotherapie. 2006;54(3):213–223. doi: 10.1024/1661-4747.54.3.213.
    1. Ransom S, Jacobsen PB, Booth-Jones M. Validation of the distress thermometer with bone marrow transplant patients. Psychooncology. 2006;15(7):604–12. doi: 10.1002/pon.993.
    1. Schroevers MJ, Sanderman R, van Sonderen E, Ranchor AV. The evaluation of the Center for Epidemiologic Studies Depression (CES-D) scale: Depressed and Positive Affect in cancer patients and healthy reference subjects. Qual Life Res. 2000;9(9):1015–29. doi: 10.1023/A:1016673003237.
    1. Lohaus A, Schmitt G. Fragebogen zur Erhebung von Kontrollüberzeugung zu Krankheit und Gesundheit (KKG). Handanweisung. Göttingen, Toronto: Zürich, Hogrefe; 1989.
    1. Wallston KA, Wallston BS, DeVellis R. Development of the Multidimensional Health Locus of Control (MHLC) Scales. Health Educ Monogr. 1978;6(2):160–70. doi: 10.1177/109019817800600107.
    1. Reitan RM. The relation of the trail making test to organic brain damage. J Consult Psychol. 1955;19(5):393–4. doi: 10.1037/h0044509.
    1. Sanchez-Cubillo I, Perianez JA, Adrover-Roig D, Rodriguez-Sanchez JM, Rios-Lago M, Tirapu J, et al. Construct validity of the Trail Making Test: role of task-switching, working memory, inhibition/interference control, and visuomotor abilities. J Int Neuropsychol Soc. 2009;15(3):438–50. doi: 10.1017/S1355617709090626.
    1. Thomas ED, Storb R, Clift RA, Fefer A, Johnson L, Neiman PE, et al. Bone-marrow transplantation (second of two parts) N Engl J Med. 1975;292(17):895–902. doi: 10.1056/NEJM197504242921706.
    1. Beller EM, Gebski V, Keech AC. Randomisation in clinical trials. Med J Aust. 2002;177(10):565–7.
    1. Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43(7):1334–59. doi: 10.1249/MSS.0b013e318213fefb.
    1. American College of Sports American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc. 2009;41(3):687–708. doi: 10.1249/MSS.0b013e3181915670.
    1. Bourke L, Homer KE, Thaha MA, Steed L, Rosario DJ, Robb KA, et al. Interventions for promoting habitual exercise in people living with and beyond cancer. Cochrane Database Syst Rev. 2013;9
    1. Winters-Stone KM, Neil SE, Campbell KL. Attention to principles of exercise training: a review of exercise studies for survivors of cancers other than breast. Br J Sports Med. 2014;48(12):987–995. doi: 10.1136/bjsports-2012-091732.
    1. Bernstein D, Borkovec T. Progressive relaxation training: a manual for the helping profession. Champaign, IL: Research Press; 1973.
    1. Yang L, Tsiatis A. Efficiency study of estimators for a treatment effect in a pretest-posttest trial. Am Stat. 2001;55:314–21. doi: 10.1198/000313001753272466.
    1. Beavers KM, Brinkley TE, Nicklas BJ. Effect of exercise training on chronic inflammation. Clin Chim Acta. 2010;411(11–12):785–93. doi: 10.1016/j.cca.2010.02.069.
    1. Fairey AS, Courneya KS, Field CJ, Bell GJ, Jones LW, Martin BS, et al. Effect of exercise training on C-reactive protein in postmenopausal breast cancer survivors: a randomized controlled trial. Brain Behav Immun. 2005;19(5):381–8. doi: 10.1016/j.bbi.2005.04.001.
    1. Donges CE, Duffield R, Drinkwater EJ. Effects of resistance or aerobic exercise training on interleukin-6, C-reactive protein, and body composition. Med Sci Sports Exerc. 2010;42(2):304–13. doi: 10.1249/MSS.0b013e3181b117ca.
    1. Campbell PT, Campbell KL, Wener MH, Wood BL, Potter JD, McTiernan A, et al. A yearlong exercise intervention decreases CRP among obese postmenopausal women. Med Sci Sports Exerc. 2009;41(8):1533–9. doi: 10.1249/MSS.0b013e31819c7feb.
    1. Petersen AM, Pedersen BK. The anti-inflammatory effect of exercise. J Appl Physiol. 2005;98(4):1154–62. doi: 10.1152/japplphysiol.00164.2004.
    1. Pierce BL, Ballard-Barbash R, Bernstein L, Baumgartner RN, Neuhouser ML, Wener MH, et al. Elevated biomarkers of inflammation are associated with reduced survival among breast cancer patients. J Clin Oncol. 2009;27(21):3437–44. doi: 10.1200/JCO.2008.18.9068.
    1. Fiuza-Luces C, Soares-Miranda L, Gonzalez-Murillo A, Palacio JM, Colmenero I, Casco F, et al. Exercise benefits in chronic graft versus host disease: a murine model study. Med Sci Sports Exerc. 2013;45(9):1703–1711. doi: 10.1249/MSS.0b013e31828fa004.
    1. Dietrich S, Falk CS, Benner A, Karamustafa S, Hahn E, Andrulis M, et al. Endothelial vulnerability and endothelial damage are associated with risk of graft-versus-host disease and response to steroid treatment. Biol Blood Marrow Transplant. 2013;19(1):22–7. doi: 10.1016/j.bbmt.2012.09.018.
    1. Luft T, Dietrich S, Falk C, Conzelmann M, Hess M, Benner A, et al. Steroid-refractory GVHD: T-cell attack within a vulnerable endothelial system. Blood. 2011;118(6):1685–92. doi: 10.1182/blood-2011-02-334821.
    1. Lin MT, Storer B, Martin PJ, Tseng LH, Gooley T, Chen PJ, et al. Relation of an interleukin-10 promoter polymorphism to graft-versus-host disease and survival after hematopoietic-cell transplantation. N Engl J Med. 2003;349(23):2201–10. doi: 10.1056/NEJMoa022060.
    1. Choi SW, Kitko CL, Braun T, Paczesny S, Yanik G, Mineishi S, et al. Change in plasma tumor necrosis factor receptor 1 levels in the first week after myeloablative allogeneic transplantation correlates with severity and incidence of GVHD and survival. Blood. 2008;112(4):1539–42. doi: 10.1182/blood-2008-02-138867.
    1. Zeng D, Lewis D, Dejbakhsh-Jones S, Lan F, Garcia-Ojeda M, Sibley R, et al. Bone marrow NK1.1(−) and NK1.1(+) T cells reciprocally regulate acute graft versus host disease. J Exp Med. 1999;189(7):1073–81. doi: 10.1084/jem.189.7.1073.
    1. Palmer JM, Rajasekaran K, Thakar MS, Malarkannan S. Clinical relevance of natural killer cells following hematopoietic stem cell transplantation. J Cancer Educ. 2013;4(1):25–35. doi: 10.7150/jca.5049.
    1. Na YM, Kim MY, Kim YK, Ha YR, Yoon DS. Exercise therapy effect on natural killer cell cytotoxic activity in stomach cancer patients after curative surgery. Arch Phys Med Rehabil. 2000;81(6):777–9. doi: 10.1016/S0003-9993(00)90110-2.
    1. Timmons BW, Cieslak T. Human natural killer cell subsets and acute exercise: a brief review. Exerc Immunol Rev. 2008;14:8–23.
    1. Kim S, Kim H. A series of bed exercises to improve lymphocyte count in allogenic bone marrow transplantation patients. Eur J Cancer Care. 2006;15:453–457. doi: 10.1111/j.1365-2354.2006.00668.x.
    1. Kim DH, Kim JG, Sohn SK, Sung WJ, Suh JS, Lee KS, et al. Clinical impact of early absolute lymphocyte count after allogeneic stem cell transplantation. Br J Haematol. 2004;125(2):217–24. doi: 10.1111/j.1365-2141.2004.04891.x.
    1. Shilling HG, McQueen KL, Cheng NW, Shizuru JA, Negrin RS, Parham P. Reconstitution of NK cell receptor repertoire following HLA-matched hematopoietic cell transplantation. Blood. 2003;101(9):3730–40. doi: 10.1182/blood-2002-08-2568.
    1. Dimeo F, Fetscher S, Lange W, Mertelsmann R, Keul J. Effects of aerobic exercise on the physical performance and incidence of treatment-related complications after high-dose chemotherapy. Blood. 1997;90(9):3390–4.
    1. Bower JE. Cancer-related fatigue--mechanisms, risk factors, and treatments. Nat Rev Clin Oncol. 2014;11(10):597–609. doi: 10.1038/nrclinonc.2014.127.
    1. Wang XS, Shi Q, Williams LA, Cleeland CS, Mobley GM, Reuben JM, et al. Serum interleukin-6 predicts the development of multiple symptoms at nadir of allogeneic hematopoietic stem cell transplantation. Cancer. 2008;113(8):2102–9. doi: 10.1002/cncr.23820.
    1. Meyers CA, Albitar M, Estey E. Cognitive impairment, fatigue, and cytokine levels in patients with acute myelogenous leukemia or myelodysplastic syndrome. Cancer. 2005;104(4):788–93. doi: 10.1002/cncr.21234.
    1. Jarden M, Nelausen K, Hovgaard D, Boesen E, Adamsen L. The effect of a multimodal intervention on treatment-related symptoms in patients undergoing hematopoietic stem cell transplantation: a randomized controlled trial. J Pain Symptom Manage. 2009;38(2):174–90. doi: 10.1016/j.jpainsymman.2008.09.005.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner