Higher exercise tolerance early after allogeneic hematopoietic stem cell transplantation is the predictive marker for higher probability of later social reintegration.
Higher exercise tolerance early after allogeneic hematopoietic stem cell transplantation is the predictive marker for higher probability of later social reintegration.
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DOI：
10.1038/s41598-021-86744-8
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发表时间：
2021-03-30
影响因子：
4.6
通讯作者：
Matsuda S
中科院分区：
文献类型：
--
作者：
Hamada R;Arai Y;Kondo T;Harada K;Murao M;Miyasaka J;Yoshida M;Yonezawa H;Nankaku M;Ouchi S;Kitakubo W;Wadayama T;Kanda J;Takaori-Kondo A;Ikeguchi R;Matsuda S
随着异基因造血干细胞移植（allo-HSCT）后长期存活者的比例不断上升，有必要考虑生活质量（QOL）的重要性，包括重返社会（重返学校或工作）。这项回顾性队列研究旨在说明allo-HSCT后社会再融合的精确流行病学，并确定其预测指标。我们招募了56名患者，40名患者（71%）在HSCT后2年实现了社会重新融合。再整合失败与较差的体能状态和并发慢性移植物抗宿主病显著相关。在非再整合患者中，出院时通过6分钟步行距离（6 MWD）测量的身体功能显著降低。在多变量风险分析中，性别（女性;比值比（OR）0.07; 95%置信区间（CI）0.01-0.54; p = 0.01），HCT-CI（≥ 2; OR 0.10; 95% CI 0.01-0.84; p = 0.03）和6 MWD的变化（每增加5%; OR 1.47; 95% CI 1.01-2.13; p = 0.04）是后期重返社会的重要预测因素。这项研究表明，包括康复在内的多学科策略是必不可少的，特别是在早期阶段预测指标较差的患者中，我们应该考虑合适的康复计划，以防止allo-HSCT后患者运动耐量下降，改善社会融合和整体生活质量。
As the proportion of long-term survivors after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is on the rise, it is essential to consider the significance of quality of life (QOL), including reintegration with society (returning to school or work). This retrospective cohort study aims to illustrate the precise epidemiology of social reintegration later after allo-HSCT and determine its predictive indicators. We enrolled 56 patients, and 40 patients (71%) attained social reintegration at 2 years post-HSCT. Reintegration failure markedly correlated with an inferior performance status and concurrent chronic graft-versus-host disease. In non-reintegrated patients, the physical function at discharge measured by the 6-min walking distance (6MWD) was markedly decreased. On the multivariate risk analyses, sex (female; odds ratio (OR) 0.07; 95% confidence interval (CI) 0.01–0.54; p = 0.01), HCT-CI (≥ 2; OR 0.10; 95% CI 0.01–0.84; p = 0.03), and change in 6MWD (per 5% increase; OR 1.47; 95% CI 1.01–2.13; p = 0.04) were significant predictors of later social reintegration. This study suggests that a multidisciplinary strategy including rehabilitation is essential, especially in patients with poor predictive markers at an early phase, and we should consider suitable rehabilitation programs to prevent a decline in exercise tolerance and improve social reintegration and overall QOL in patients after allo-HSCT.
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影响因子：
4.3
作者：
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