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Effect of the severity of acute graft-versus-host disease on physical function after allogeneic hematopoietic stem cell transplantation

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Abstract

Purpose

The purpose of this study was to retrospectively investigate the effect of the severity of acute graft-versus-host disease (GVHD) on physical function after allogeneic hematopoietic stem cell transplantation (allo-HSCT).

Methods

76 patients were included as subjects of this study. Severity of acute GVHD was classified according to the method defined by Grucksberg. To evaluate physical function, the knee extensor strength and six-minute walk distance (6MWD) were performed.

Results

Among these patients, 54% developed acute GVHD; of these, 32%, 54%, and 15% of patients had grade I, grade II, and grades III–IV GVHD, respectively. In the grade I–II groups, mild acute GVHD following allo-HSCT resulted in a gradual decline in physical function, which improved at discharge. However, in cases of severe acute GVHD, physical function deteriorated, implementation of rehabilitation became difficult, and the decline in physical function persisted even at discharge.

Conclusion

These results indicate that severe acute GVHD negatively affects physical function leading to longer hospital days because of inadequate rehabilitation interventions.

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Acknowledgements

We are grateful to the medical, nursing, and laboratory staff of the participating departments for their contributions to this study.

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Authors and Affiliations

  1. Rehabilitation Unit, Kyoto University Hospital, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Ryota Hamada, Masanobu Murao, Jyunsuke Miyasaka, Michiko Yoshida, Manabu Nankaku, Ryosuke Ikeguchi & Shuichi Matsuda

  2. Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Tadakazu Kondo, Junya Kanda & Akifumi Takaori-Kondo

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Correspondence to Tadakazu Kondo.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Institutional Review Board of Kyoto University Hospital conducted in accordance with the international ethical recommendations stated in the Japanese Good Clinical Practice Guidelines.

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Hamada, R., Kondo, T., Murao, M. et al. Effect of the severity of acute graft-versus-host disease on physical function after allogeneic hematopoietic stem cell transplantation. Support Care Cancer 28, 3189–3196 (2020). https://doi.org/10.1007/s00520-019-05124-1

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