Rationale and design of APOLLO: a personalized rehAbilitation PrOgram in aLLOgeneic bone marrow transplantation
Abstract Background Hematopoietic stem cell transplantation (HSCT) is a common therapy for many hematologic malignancies. While advances in transplant practice have improved cancer-specific outcomes, multiple and debilitating long term physical and psychologic effects remain. Patients undergoing all...
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2025-01-01
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| author | Edith Pituskin Stephen Foulkes Rachel J. Skow Thomas McMurtry Calvin Kruger Janet E. Bates Daena Lamoureux Joseph Brandwein Elena Lieuw Cynthia Wu Nancy Zhu Peng Wang Daniel Sawler Minakshi Taparia Marlene Hamilton Tiffany Comfort-Riddle Tara Meyer Gabor T. Gyenes Ian Paterson Carla M. Prado Mark J. Haykowsky Justin G. Greiner Margaret L. McNeely Puneeta Tandon Richard B. Thompson |
| author_facet | Edith Pituskin Stephen Foulkes Rachel J. Skow Thomas McMurtry Calvin Kruger Janet E. Bates Daena Lamoureux Joseph Brandwein Elena Lieuw Cynthia Wu Nancy Zhu Peng Wang Daniel Sawler Minakshi Taparia Marlene Hamilton Tiffany Comfort-Riddle Tara Meyer Gabor T. Gyenes Ian Paterson Carla M. Prado Mark J. Haykowsky Justin G. Greiner Margaret L. McNeely Puneeta Tandon Richard B. Thompson |
| author_sort | Edith Pituskin |
| collection | DOAJ |
| description | Abstract Background Hematopoietic stem cell transplantation (HSCT) is a common therapy for many hematologic malignancies. While advances in transplant practice have improved cancer-specific outcomes, multiple and debilitating long term physical and psychologic effects remain. Patients undergoing allogeneic bone marrow transplantation (allo-BMT) are often critically ill at initial diagnosis and with necessary sequential treatments become increasingly frail and deconditioned. Despite modern treatment regimens and support, cardiovascular disease remains a leading cause of non-relapse mortality among allo-BMT survivors. Well-established multi-disciplinary care models such as cardiac rehabilitation offer holistic care including exercise training, nursing support, physical/occupational therapy, psychosocial support and nutritional education. HSCT patients may be excluded from conventional outpatient physical rehabilitation programs due to prolonged pancytopenia and frequent hospital admissions. In Canada, dedicated cancer-specific rehabilitation programs are available only at major tertiary academic centers. Methods The primary aim of this study will evaluate the feasibility and acceptability of a multimodal care navigation (nursing, exercise, nutrition) intervention with content delivery facilitated by a supportive care web-based ‘app’ extending from diagnosis to 1 year in the allogeneic bone marrow transplant population. Adult patients scheduled for allo-BMT will receive support from exercise specialist, nursing support and dietician expertise alongside a supportive care ‘app’ with additional in-person or virtual cardiac rehabilitation support. Discussion To our knowledge, no research team is taking such a holistic, multidisciplinary approach to address the debilitating physiologic and psychological consequences of allo-BMT. We expect the findings to inform the optimal timing and patient preferences to develop studies examining risk-specific, individualized interventions (including exercise, pharmacotherapy, combination treatments) to reduce or prevent symptoms and dysfunction. We expect this innovative program to identify ways to benefit innumerable patients with hematologic and other malignancies. Ultimately, we hope to transform supportive care in hematopoietic stem cell transplantation. Trial Registration Clinicaltrials.gov ID: NCT05579678. |
| format | Article |
| id | doaj-art-38b23117ca8844d98606dee89b72b673 |
| institution | Kabale University |
| issn | 1471-2407 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Cancer |
| spelling | doaj-art-38b23117ca8844d98606dee89b72b6732025-02-02T12:28:54ZengBMCBMC Cancer1471-24072025-01-012511710.1186/s12885-025-13502-8Rationale and design of APOLLO: a personalized rehAbilitation PrOgram in aLLOgeneic bone marrow transplantationEdith Pituskin0Stephen Foulkes1Rachel J. Skow2Thomas McMurtry3Calvin Kruger4Janet E. Bates5Daena Lamoureux6Joseph Brandwein7Elena Lieuw8Cynthia Wu9Nancy Zhu10Peng Wang11Daniel Sawler12Minakshi Taparia13Marlene Hamilton14Tiffany Comfort-Riddle15Tara Meyer16Gabor T. Gyenes17Ian Paterson18Carla M. Prado19Mark J. Haykowsky20Justin G. Greiner21Margaret L. McNeely22Puneeta Tandon23Richard B. Thompson24Faculty of Nursing, University of AlbertaFaculty of Nursing, University of AlbertaFaculty of Nursing, University of AlbertaFaculty of Nursing, University of AlbertaFaculty of Nursing, University of AlbertaFaculty of Nursing, University of AlbertaFaculty of Nursing, University of AlbertaFaculty of Medicine & Dentistry, University of AlbertaFaculty of Medicine & Dentistry, University of AlbertaFaculty of Medicine & Dentistry, University of AlbertaFaculty of Medicine & Dentistry, University of AlbertaFaculty of Medicine & Dentistry, University of AlbertaFaculty of Medicine & Dentistry, University of AlbertaFaculty of Medicine & Dentistry, University of AlbertaFaculty of Medicine & Dentistry, University of AlbertaAlberta Health ServicesAlberta Health ServicesAlberta Health ServicesUniversity of Ottawa Heart InstituteDepartment of Agricultural, Food and Nutritional Science, University of AlbertaFaculty of Nursing, University of AlbertaDepartment of Radiology and Diagnostic Imaging, University of AlbertaDepartment of Physical Therapy, University of AlbertaDepartment of Medicine, Division of Gastroenterology (Liver Unit), University of AlbertaDepartment of Radiology and Diagnostic Imaging, University of AlbertaAbstract Background Hematopoietic stem cell transplantation (HSCT) is a common therapy for many hematologic malignancies. While advances in transplant practice have improved cancer-specific outcomes, multiple and debilitating long term physical and psychologic effects remain. Patients undergoing allogeneic bone marrow transplantation (allo-BMT) are often critically ill at initial diagnosis and with necessary sequential treatments become increasingly frail and deconditioned. Despite modern treatment regimens and support, cardiovascular disease remains a leading cause of non-relapse mortality among allo-BMT survivors. Well-established multi-disciplinary care models such as cardiac rehabilitation offer holistic care including exercise training, nursing support, physical/occupational therapy, psychosocial support and nutritional education. HSCT patients may be excluded from conventional outpatient physical rehabilitation programs due to prolonged pancytopenia and frequent hospital admissions. In Canada, dedicated cancer-specific rehabilitation programs are available only at major tertiary academic centers. Methods The primary aim of this study will evaluate the feasibility and acceptability of a multimodal care navigation (nursing, exercise, nutrition) intervention with content delivery facilitated by a supportive care web-based ‘app’ extending from diagnosis to 1 year in the allogeneic bone marrow transplant population. Adult patients scheduled for allo-BMT will receive support from exercise specialist, nursing support and dietician expertise alongside a supportive care ‘app’ with additional in-person or virtual cardiac rehabilitation support. Discussion To our knowledge, no research team is taking such a holistic, multidisciplinary approach to address the debilitating physiologic and psychological consequences of allo-BMT. We expect the findings to inform the optimal timing and patient preferences to develop studies examining risk-specific, individualized interventions (including exercise, pharmacotherapy, combination treatments) to reduce or prevent symptoms and dysfunction. We expect this innovative program to identify ways to benefit innumerable patients with hematologic and other malignancies. Ultimately, we hope to transform supportive care in hematopoietic stem cell transplantation. Trial Registration Clinicaltrials.gov ID: NCT05579678.https://doi.org/10.1186/s12885-025-13502-8Allogeneic bone marrow transplantDeconditioningMalnutritionCardiac rehabilitationMRISarcopenia |
| spellingShingle | Edith Pituskin Stephen Foulkes Rachel J. Skow Thomas McMurtry Calvin Kruger Janet E. Bates Daena Lamoureux Joseph Brandwein Elena Lieuw Cynthia Wu Nancy Zhu Peng Wang Daniel Sawler Minakshi Taparia Marlene Hamilton Tiffany Comfort-Riddle Tara Meyer Gabor T. Gyenes Ian Paterson Carla M. Prado Mark J. Haykowsky Justin G. Greiner Margaret L. McNeely Puneeta Tandon Richard B. Thompson Rationale and design of APOLLO: a personalized rehAbilitation PrOgram in aLLOgeneic bone marrow transplantation BMC Cancer Allogeneic bone marrow transplant Deconditioning Malnutrition Cardiac rehabilitation MRI Sarcopenia |
| title | Rationale and design of APOLLO: a personalized rehAbilitation PrOgram in aLLOgeneic bone marrow transplantation |
| title_full | Rationale and design of APOLLO: a personalized rehAbilitation PrOgram in aLLOgeneic bone marrow transplantation |
| title_fullStr | Rationale and design of APOLLO: a personalized rehAbilitation PrOgram in aLLOgeneic bone marrow transplantation |
| title_full_unstemmed | Rationale and design of APOLLO: a personalized rehAbilitation PrOgram in aLLOgeneic bone marrow transplantation |
| title_short | Rationale and design of APOLLO: a personalized rehAbilitation PrOgram in aLLOgeneic bone marrow transplantation |
| title_sort | rationale and design of apollo a personalized rehabilitation program in allogeneic bone marrow transplantation |
| topic | Allogeneic bone marrow transplant Deconditioning Malnutrition Cardiac rehabilitation MRI Sarcopenia |
| url | https://doi.org/10.1186/s12885-025-13502-8 |
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