Tyler Ketterl

and 8 more

BACKGROUND Adolescent and young adult (AYA) hematopoietic cell transplantation (HCT) survivors are at increased risk of metabolic syndrome and lean body mass (LBM) deficits. Resistance training (RT) is a potential intervention to improve LBM, metabolic fitness and reduce risk of cardiovascular disease. PROCEDURE Eligible participants ages 13-39 years, 80-120 days post-HCT, transfusion independent, and prednisone dose <1 mg/kg/day were approached. Baseline assessments of body composition (DXA), anthropometrics and strength testing were completed and participants were taught a 12-week, home-based RT intervention with weekly remote coaching. Follow-up assessments were at day +200 (FU1) and +365 post-HCT (FU2). Feasibility targets were 1) 60% enrollment of approached patients, 2) 80% completion of weekly phone calls and 3) 80% completion of the RT intervention and FU1 assessments. Acceptability was measured by recommendation of the intervention to an AYA HCT survivor. RESULTS Twenty of 31 (65%) eligible AYAs enrolled. Two participants failed to complete baseline measurements (1=scheduling barriers, 1=passive refusal) and 4 participants who completed baseline assessments did not receive the intervention (2=medical reasons, 2=no longer interested). Of the 13 who received the intervention, 11 (85%) completed FU1 and completed 88.5% of coaching calls. LBM (kg) increased or remained unchanged in 9/9 participants with complete body composition data at FU1 (mean 1.1 kg; 95%CI: 0.4,1.9). All participants who completed FU1 reported they would recommend the intervention to an AYA HCT survivor. CONCLUSIONS A home-based RT intervention in AYA HCT survivors early post HCT is both feasible and acceptable and may maintain or increase LBM.

Erica Roelofs

and 5 more

Background: Childhood cancer survivors (CCS) who receive a hematopoietic cell transplantation (HCT) are at increased risk for follicle-stimulating hormone (FSH) and luteinizing hormone (LH) abnormalities, which may have a substantial negative impact on vascular function. This study’s purpose was to examine the association of vascular function with FSH and LH in HCT recipients, non-HCT recipients and healthy controls. Procedures: The study included CCS who were HCT recipients (n=24) and non-HCT recipients (n=308), and a control group of healthy siblings (n=211) all aged between 9-18 years. Vascular measures of carotid artery structure and function (compliance and distensibility), brachial artery flow-mediated dilation (FMD) and nitroglycerin-mediated endothelial-independent dilation (EID) were measured using ultrasound imaging. FSH, LH, testosterone (males only), and estrogen (females only) were measured from a fasting blood sample. Results: FSH was significantly higher in HCT recipients compared to non-HCT recipients and healthy controls (p<0.01). The groups did not differ significantly for LH, testosterone, or estrogen. Carotid compliance and distensibility were significantly lower in HCT and non-HCT recipients compared to healthy controls (p<0.05). FMD and EID did not differ significantly between groups. Higher FSH was associated with decreased carotid compliance (p<0.05). Higher testosterone was associated with lower EID (p<0.05). Conclusion: This study’s results suggest that higher levels of FSH in HCT recipients may result in significant reductions in vascular function compared to non-HCT recipients and healthy controls. Therefore, endocrine dysfunction, particularly abnormal FSH levels, may be an underlying mechanism of vascular dysfunction.