Real-World Outcomes of an Exercise Program Following Hematopoietic Stem Cell Transplantation

Exercise is an effective therapy to address physical and psychosocial consequences of hematopoietic stem cell transplantation (HSCT), yet evidence on real-world effectiveness initiated post-HSCT is limited. This study retrospectively evaluated a community-embedded exercise program integrated into routine care at an urban cancer center, with a secondary aim of exploring how baseline physical function influences exercise response. Methods: – The Living Well Program is an evidence-based program supervised by Accredited Exercise Physiologists, delivered at Chris O’Brien Lifehouse. HSCT recipients are prescribed individualized, once-weekly 1-h aerobic, resistance, and balance training for 8 wk. Changes in physical function, fatigue, and quality of life from baseline to postintervention were assessed using paired t tests or Wilcoxon signed-rank tests. Hedge’s g indicated the magnitude of the effect. Associations with attendance were examined, and participants were stratified as low- or high-function for each physical function measure. Results: – Forty-eight participants (male n = 27, age = 54.3 ± 11.7 yr) were included. Significant improvements occurred across all physical outcome measures (P ≤ 0.05), with large and moderate effects for 6-min walk distance (g = 0.86, 95% CI: 0.36–1.36) and 30-s sit-to-stand (g = 0.68, 95% CI: 0.05–1.31), respectively, both exceeding minimal clinically important differences. Attendance correlated moderately with leg strength gains (r = 0.41). Participants with lower baseline 6-min walk distance demonstrated significantly greater gains than those with higher baseline scores (P < 0.001). Conclusion: – Despite variability in data collection inherent to the real-world setting, findings support the clinical effectiveness of an existing exercise program embedded in cancer care. These findings support the value of integrating tailored exercise into post-HSCT care pathways, particularly for those with low physical function who may receive the greatest benefit.