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Saillard C, Cuvelier S, Villaron-Goetgheluck C, Boher JM, Almeida-Lopez L, Le Corroller AG, Denis P, Rivieccio C, Calvin S, Vey N, Bannier-Braticevic C. Tripartite prehabilitation of patients with acute myeloid leukaemia and high-risk myelodysplastic syndromes during intensive chemotherapy before allogeneic haematopoietic stem cell transplantation (COHABILIT): protocol for an innovating prospective multicentre study. BMJ Open 2024; 14:e076321. [PMID: 38553062 PMCID: PMC10982723 DOI: 10.1136/bmjopen-2023-076321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 03/07/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVES Acute myeloid leukaemia (AML) and high-risk myelodysplastic syndromes (MDS) are often treated with intensive chemotherapy followed by allogeneic haematopoietic stem cell transplantation (allo-HSCT). The pretransplant treatment results in a general deterioration of the patient's health and quality of life. Furthermore, allo-HSCT can be responsible for significant toxicity with risks of graft-versus-host disease (GvHD). Developing strategies to prevent physical deconditioning, undernutrition and psychological distress could help maintain a satisfactory general state of health before transplantation and thus limit these deleterious effects. This protocol evaluates the feasibility and adherence to a personalised prehabilitation programme, which can be modulated and assisted by connected objects, provided from the diagnosis to the allo-HSCT. METHODS AND ANALYSIS This multicentre interventional study will include 50 patients treated for AML or high-risk MDS with intensive chemotherapy and eligible for allo-HSCT. The intervention consists of a coached, supervised or self-directed physical activity programme, organised during the hospitalisation phases and periods at home. At the same time, patients will receive a weekly dietary follow-up. The whole intervention is controlled and modulated through the use of a dedicated application and connected objects allowing adaptation and individualisation. The rate of participation in the prescribed physical activity sessions will assess the feasibility of this study. In addition, the evolution of physical capacities (Short Physical Performance Battery, grip and quadriceps strengths), psychosocial parameters (Functional Assessment of Cancer Therapy - Leukaemia, Functional Assessment of Cancer Therapy - Fatigue, subjective well-being, Hospital Anxiety and Depression Scale, self-efficacy, Coach-Athlete Relationship Questionnaire, interviews) and clinical status (weight, lean body mass, survival rate, number of infections, days of hospitalisation, GvHD) will be evaluated. ETHICS AND DISSEMINATION The study procedures have been approved by the National Ethics Committee (21.00223.000003). Consent is given in person by each participant. The information collected on the participants contains only a non-identifiable study identifier. The results of this protocol will be published in a scientific paper and communicated to the medical staff of the medical centre. TRIAL REGISTRATION NUMBER NCT03595787.
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Affiliation(s)
- Colombe Saillard
- Department of Haematology, Paoli-Calmettes Institute, Marseille, France
| | - Sarah Cuvelier
- Management Sport Cancer Laboratory, Aix-Marseille University, Marseille, France
| | | | - Jean-Marie Boher
- Department of Clinical Research and Innovations, Paoli-Calmettes Institute, Marseille, France
| | - Leonor Almeida-Lopez
- Department of Clinical Research and Innovations, Paoli-Calmettes Institute, Marseille, France
| | - Anne-Gaelle Le Corroller
- Economic and Social Sciences of Health and Medical Information Processing Laboratory (SESSTIM CANBIOS), National Institute of Health and Medical Research, Paris, France
| | - Pauline Denis
- Department of Sport, Paoli-Calmettes Institute, Marseille, France
| | - Céline Rivieccio
- Department of Sport, Paoli-Calmettes Institute, Marseille, France
| | - Sarah Calvin
- Management Sport Cancer Laboratory, Aix-Marseille University, Marseille, France
| | - Norbert Vey
- Department of Haematology, Paoli-Calmettes Institute, Marseille, France
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Casirati A, Salcedo I, Cereda E, Chabannon C, Ruggeri A, Kuball J, Clout R, Mooyaart JE, Kenyon M, Caccialanza R, Pedrazzoli P, Kisch AM. The European Society for Blood and Marrow Transplantation (EBMT) roadmap and perspectives to improve nutritional care in patients undergoing hematopoietic stem cell transplantation on behalf of the Cellular Therapy and Immunobiology Working Party (CTIWP) and the Nurses Group (NG) of the EBMT. Bone Marrow Transplant 2023; 58:965-972. [PMID: 37407728 DOI: 10.1038/s41409-023-02018-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 05/10/2023] [Accepted: 06/07/2023] [Indexed: 07/07/2023]
Abstract
Malnutrition is the most common comorbidity during the continuum of hematopoietic stem cell transplant (HSCT) and negatively impacts clinical outcomes, response to therapy, quality of life, and costs. The intensive conditioning regimen administered before transplant causes inflammatory damages to the gastrointestinal system, which themselves contribute to trigger graft versus host disease (GvHD) in the allogeneic setting. GvHD and other post-transplant complications such as infections adversely affect food intake and gut absorption of nutrients. Consequently, patients exhibit signs of malnutrition such as weight loss and muscle wasting, thus triggering a "vicious circle" that favours additional complications. Among HSCT centres, there is marked variability in nutritional care, from screening for malnutrition to nutritional intervention. The present paper, elaborated by the Cellular Therapy and Immunobiology Working Party and the Nurses Group of the European Society for Blood and Marrow Transplantation, aims at defining a roadmap that identifies the main nutritional critical issues in the field of HSCT. This document will be propaedeutic to the development of clinical algorithms to counteract risk factors of malnutrition, based on scientific evidence and shared among HSCT centres, and thus maximize transplant outcomes.
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Affiliation(s)
- Amanda Casirati
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Isabel Salcedo
- Department of Hematology, Hospital Universitario Puerta de Hierro Majadahonda, IDIPHISA, Madrid, Spain
| | - Emanuele Cereda
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Christian Chabannon
- Centre de Thérapie Cellulaire & Centre d'Investigations Cliniques en Biothérapies Inserm CBT-1409, Institut Paoli-Calmettes, Marseille, France
| | - Annalisa Ruggeri
- Hematology and BMT Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Jurgen Kuball
- Department of Hematology and Center for Translational Immunology, UMC Utrecht, Utrecht, The Netherlands
| | - Ruth Clout
- Department of Haematology and Transplant Unit, The Christie Hospital, Manchester, United Kingdom
| | | | - Michelle Kenyon
- Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Riccardo Caccialanza
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Paolo Pedrazzoli
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy.
- Department of Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - Annika M Kisch
- Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden and Institute of Health Sciences, Lund University, Lund, Sweden
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Cuvelier S, Goetgheluck-Villaron C, Cohen M, Tallet A, Berline M, Boher J, Jowett S, Justafré S, Dantin P, Viens P, Calvin S. Aqua polo: Preliminary feasibility and efficacy study of a programme of adapted, supervised water polo to reduce fatigue and improve women's psychological and social recovery after breast cancer treatment: A mixed-methods design. Contemp Clin Trials Commun 2023; 33:101120. [PMID: 37026030 PMCID: PMC10070369 DOI: 10.1016/j.conctc.2023.101120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/01/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023] Open
Abstract
Physical activity has been shown to have many benefits, including reducing cancer-related fatigue (CRF) and improving psychological and physical recovery from breast cancer. Some authors have shown the benefits of aquatic practice, while others have detailed the benefits of group and supervised practice. We hypothesize that an innovative sports coaching proposal could allow a significant adherence of patients and contribute to their health improvement. The main objective is to study the feasibility of an adapted water polo programme (aqua polo) for women after breast cancer. Secondarily we will analyse the effect of such a practice on patients' recovery and study the relationship between coaches and participants. The use of mixed methods will allow us to question the underlying processes precisely. This is a prospective, non-randomized, monocentric study with a sample of 24 breast cancer patients after treatment. The intervention is a 20 week programme (1 session per week) of aqua polo in a swim club facility, supervised by professional water-polo coaches. The variables measured are patient participation, quality of life (QLQ BR23), CRF (R-PFS) and post-traumatic growth (PTG-I) as well as different variables to observe physical capacity (strength with dynamometer, step-test and arm amplitude). The quality of the coach-patient relationship will be evaluated (CART-Q) to explore its dynamics. Participatory observations and interviews will be carried out to report on the interactions between the coach and the participants during the sessions. Registration number and name of trial registry No. EudraCT or ID-RCB: 2019-A03003-54 and NCT: NCT04235946.
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Cuvelier S, Blaise D, Boher JM, Villaron-Goetgheluck C, Justafré S, Pakradouni J, Granata A, Furst S, Dantin P, Viens P, Calvin S. A study of elite sport-inspired coaching for patients after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2021; 56:2755-2762. [PMID: 34262141 PMCID: PMC8277989 DOI: 10.1038/s41409-021-01401-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/16/2021] [Accepted: 06/25/2021] [Indexed: 11/20/2022]
Abstract
A need for social support is often expressed after hospitalization post HSCT. Emotional support and positive psychological constructs play an important role in post-HSCT recovery. Interventions generating positive affect can influence the health and well-being of transplant patients. It has been established that coaching in elite sport area leads to performance by playing a decisive role in maintaining the athlete’s feelings of hope and autonomy in order to enable him or her to achieve their goals. In this single-center, prospective, one-arm study, we evaluated, in 32 post-HSCT patients, the acceptability of a coaching program inspired by elite sport coaching. Benefits were evaluated by questionnaires and semi-structured interviews. The coaching program was accepted by 97% of the patients. Analysis of the scores on the “Means” sub-dimension of Hope showed a significant increase over time (p = 0.0249 < 0.05) for every patient. Qualitative analysis of patient’s satisfaction pointed out that this support facilitated the transition to a life without illness in particular in the non-hospital context of coaching sessions. Our results show that a “sport-inspired coaching“ may offer an innovative approach supporting psychological and social recovery after HSCT and helping to start and/or maintain the processes leading to psychological well-being.
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Affiliation(s)
- Sarah Cuvelier
- Management Sport Cancer Laboratory (UR 20122035V), Faculty of Sport Sciences, Aix-Marseille University, Marseille, France
| | - Didier Blaise
- Department of Onco-Hematology, Transplant and Cellular Therapy Program, Institut Paoli Calmettes, Marseille, France.,Cancer Research Center of Marseille, INSERM (UMR 1068), CNRS (UMR 7258), Marseille, France
| | - Jean-Marie Boher
- Department of Clinical Research and Innovation. Institut Paoli Calmettes, Marseille, France
| | - Charlène Villaron-Goetgheluck
- Management Sport Cancer Laboratory (UR 20122035V), Faculty of Sport Sciences, Aix-Marseille University, Marseille, France
| | - Sebastien Justafré
- Management Sport Cancer Laboratory (UR 20122035V), Faculty of Sport Sciences, Aix-Marseille University, Marseille, France
| | - Jihane Pakradouni
- Department of Clinical Research and Innovation. Institut Paoli Calmettes, Marseille, France
| | - Angela Granata
- Department of Onco-Hematology, Transplant and Cellular Therapy Program, Institut Paoli Calmettes, Marseille, France
| | - Sabine Furst
- Department of Onco-Hematology, Transplant and Cellular Therapy Program, Institut Paoli Calmettes, Marseille, France
| | - Pierre Dantin
- Management Sport Cancer Laboratory (UR 20122035V), Faculty of Sport Sciences, Aix-Marseille University, Marseille, France
| | - Patrice Viens
- Management Sport Cancer Laboratory (UR 20122035V), Faculty of Sport Sciences, Aix-Marseille University, Marseille, France.,Departement of Medical Oncology, Institut Paoli Calmettes, Marseille, France
| | - Sarah Calvin
- Management Sport Cancer Laboratory (UR 20122035V), Faculty of Sport Sciences, Aix-Marseille University, Marseille, France.
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