Prognostic importance of pretransplant functional capacity after allogeneic hematopoietic cell transplantation Journal Article


Authors: Jones, L. W.; Devlin, S. M.; Maloy, M. A.; Wood, W. A.; Tuohy, S.; Espiritu, N.; Aquino, J.; Kendig, T.; Michalski, M. G.; Gyurkocza, B.; Schaffer, W. L.; Ali, B.; Giralt, S.; Jakubowski, A. A.
Article Title: Prognostic importance of pretransplant functional capacity after allogeneic hematopoietic cell transplantation
Abstract: Background. The purpose of this study was to investigate the prognostic importance of functional capacity in patients undergoing allogeneic hematopoietic cell transplantation (HCT) for hematological malignancies. Patients and Methods. Using a retrospective design, 407 patients completed a 6-minute walk distance (6MWD) test to assess functional capacity before HCT; 193 (47%) completed a 6MWD test after hospital discharge. Cox proportional hazards regression was used to estimate the risk of nonrelapse mortality (NRM) and overall survival (OS) according to the 6MWD category (<400 m vs. ≥400 m) and the change in 6MWD (before HCT to discharge) with or without adjustment for Karnofsky performance status (KPS), age, and other prognostic markers. Results. Compared with <400 m, the unadjusted hazard ratio for NRM was 0.65 (95% confidence interval, 0.44-0.96) for a 6MWD ≥400 m. A 6MWD of ≥400 m provided incremental information on the prediction of NRM with adjustment for age (p =.032) but not KPS alone (p =.062) or adjustment for other prognostic markers (p =.099). A significant association was found between the 6MWD and OS (p =.027). A 6MWD of ≥400 m provided incremental information on the prediction of OS with adjustment for age (p =.032) but not for other prognostic markers (p >.05 for all). Patients presenting with a pre-HCT 6MWD of,400 m and experiencing a decline in 6MWD had the highest risk of NRM. Conclusion. The 6MWD is a significant univariate predictor of clinical outcomes but did not provide prognostic information beyond that of traditional prognostic markers in HCT. © AlphaMed Press 2015.
Keywords: survival; adult; aged; major clinical study; overall survival; disease course; mortality; outcome assessment; follow up; exercise; retrospective study; hematologic malignancy; karnofsky performance status; comorbidity; risk stratification; allogeneic hematopoietic stem cell transplantation; hospital discharge; walking; functional status; functional capacity; cancer; prognosis; human; male; female; priority journal; article; prognostic assessment
Journal Title: The Oncologist
Volume: 20
Issue: 11
ISSN: 1083-7159
Publisher: AlphaMed Press  
Date Published: 2015-11-01
Start Page: 1290
End Page: 1297
Language: English
DOI: 10.1634/theoncologist.2015-0200
PROVIDER: scopus
PUBMED: 26446235
PMCID: PMC4718429
DOI/URL:
Notes: Export Date: 2 December 2015 -- Source: Scopus
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Citation Impact
MSK Authors
  1. Sergio Andres Giralt
    736 Giralt
  2. Molly Anna Maloy
    242 Maloy
  3. Sean McCarthy Devlin
    430 Devlin
  4. Tiffany D Kendig
    4 Kendig
  5. Sharlynn M Tuohy
    3 Tuohy
  6. Lee Winston Jones
    142 Jones
  7. Jennifer Grace   Aquino
    3 Aquino
  8. Benazir   Ali
    1 Ali