Exercise for Sarcopenia in Allogeneic Hematopoietic Stem Cell Transplant Patients

项目总结/摘要 造血干细胞移植（HSCT）是一种治疗血液病患者的有效而严格的治疗方法。 恶性肿瘤。在HSCT后的头两年，治疗相关并发症，如原发性疾病， 复发、移植物抗宿主病和HSCT治疗相关的心脏和肌肉系统毒性 估计有60-70%的存活率。HSCT引起的副作用和并发症具有晚期效应， 对患者的功能和心理健康产生负面影响。因此，HSCT接受者 有发生并发症如心血管疾病、肌肉减少症和骨质疏松症的风险。由于 HSCT症状负担增加，HSCT接受者报告体力活动水平下降58%， 进一步使骨骼肌质量损失、骨密度损失和功能能力降低持续存在。 运动已被用作HSCT受者的成功康复策略，以恢复 骨骼肌质量，肌肉力量和有氧能力，同时改善健康相关的 生活质量虽然康复锻炼是有效的，但它们并没有解决预防身体损害的作用。 和智力衰退Prehistory定义为开始药物治疗前的运动训练， 在结直肠癌和肺癌患者中， 回收轨道尽管prehistoric在其他癌症实体的好处，有一个缺乏证据， 研究接受HSCT前运动的影响。IMPROVE-BMT试验解决了这一问题 知识差距，主要侧重于监测和报告100天前的客观功能状态 移植后我将利用这项计划的临床试验（NCT 03886909）来量化和描述 联合抗阻和有氧运动预训练计划对骨骼肌质量、身体 在一些实施方案中，本发明提供了用于接受HSCT的患者的组合物和骨密度的方法。为了实现这一目标，我们将进行一个双重的- 在基线和HSCT后100天进行能量X射线吸收测定扫描。通过这次调研， 建议博士后奖学金，我将了解高质量的人体临床试验，临床 HSCT患者的运动处方，并将接受身体行为和解释方面的培训 组成测量。

Project Summary/Abstract Hematopoietic stem cell transplant (HSCT) is a curative yet rigorous treatment for patients with hematologic malignancies. During the first two years post-HSCT, treatment-related complications such as primary disease relapse, graft-versus-host-disease, and HSCT therapy-related cardio- and musculoskeletal-toxicity contribute to an estimated 60-70% survival rate. Side effects and complications caused by HSCT carry late-effects that negatively impact patients' functional capacity and psychological well-being. As a result, HSCT recipients are at risk of developing co-morbidities such as cardiovascular disease, sarcopenia, and osteoporosis. Due to the increased HSCT symptom burden, HSCT recipients report a 58% decrease in physical activity levels which further perpetuates the loss of skeletal muscle mass, bone density loss, and decreased functional capacity. Exercise has been employed as a successful rehabilitative strategy in HSCT recipients to recuperate losses in skeletal muscle mass, muscular strength and aerobic capacity while concomitantly improving health-related quality of life. While rehabilitative exercises are effective, they do not address the role of preventing physical and mental declines. Prehabilitation, defined as exercise training prior to the start of a medical therapy, has been documented to be valuable in the setting of colorectal and lung cancer patients to positively alter patients' recovery trajectory. Despite the benefits of prehabilitation in other cancer entities, there is a paucity of evidence that investigates the effects of exercise prior to receiving HSCT. The IMPROVE-BMT trial addresses this knowledge gap, with a primary focus on monitoring and reporting objective functional status until 100 days post-transplant. I will take advantage of this planned clinical trial (NCT03886909) to quantify and describe the effects of a combined resistance and aerobic exercise prehabilitation program on skeletal muscle mass, body composition, and bone density for patients receiving a HSCT. To achieve this aim we will conduct a dual- energy x-ray absorptiometry scan at baseline and 100 days post-HSCT. Through this research experience and proposed post-doctoral fellowship, I will learn about the conduct of high quality human clinical trials, clinical exercise prescription for HSCT patients, and will receive training in conduct and interpretation of body composition measurements.