Update on the risk assessment of a rehabilitation stay for patients after allogeneic stem cell transplantation

• Published in: Transplant immunology 2023-08, Vol.79, p.101865-101865, Article 101865
• Main Authors: Kiefer, Thomas, Lüders, Christian, Völler, Heinz, Daeschlein, Georg
• Format: Article
• Language: English
• Subjects: Female; Haemato-oncological patients; Hematopoietic Stem Cell Transplantation - adverse effects; Humans; Immunosuppression; Male; Rehabilitation; Risk Assessment; Risk Factors; Stem Cell Transplantation; Transplantation, Homologous
• ISSN: 0966-3274; 1878-5492
• DOI: 10.1016/j.trim.2023.101865

High-dose chemotherapy with allogeneic stem cell transplantation is the only chance of cure for many haemato-oncological patients. After such therapy, the immune system is weakened, and the contact with other people should therefore be limited as much as possible. The question arises whether a rehabilitation stay can be recommended to these patients, which risk factors for complications during the rehabilitation stay can be identified, and whether physicians and patients can be provided with decision-making aids as to when the optimal time is to start rehabilitation. We report about 161 rehabilitation stays of patients after high-dose chemotherapy with allogeneic stem cell transplantation. Premature discontinuation of the rehabilitation was selected as the criterion for a serious complication during the rehabilitation and the underlying reasons were analysed. The rate of prematurely terminated rehabilitation stays (13.6%) corresponds to our previous result from 2020. The analysis of the reasons for early termination comes to the conclusion that the rehabilitation stay is only considered as a reason for termination in very few cases, if at all. The risk factors identified for premature termination of the rehabilitation stay were male sex, the period (days) between transplantation and the beginning of the rehabilitation stay, haemoglobin value, platelets and presence of immunosuppressing agent. The most significant risk factor is a decreased platelet count at the time rehabilitation begins. The platelet count, the likelihood that it will improve in the further course and the urgency of the rehabilitation stay can be used to help decide when the optimal time for rehabilitation is given. Rehabilitation can be recommended to patients after allogeneic stem cell transplantation. Based on various factors, recommendations can be made for the right time for rehabilitation.