背景:在骨髓增生异常综合征(MDS)中,除了疾病相关的症状,许多不良事件与抗癌药有关,清髓性预处理(MAC),和异基因造血干细胞移植(allo-HSCT)。在洁净室中隔离和卧床休息严重限制了身体活动,导致心肺和肌肉无力。此外,移植后患者可能会出现全身疲劳,胃肠道症状,以及与免疫系统减弱相关的感染,以及移植物抗宿主病,导致身体功能和日常生活活动(ADL)进一步下降。大多数关于造血系统肿瘤患者康复的报道都涉及化疗或移植前后的干预措施。然而,一个重要的问题是在洁净室环境中建立有效和可行的锻炼计划,活动受到严重限制,身体功能最有可能下降。
方法:本病例报告描述了一名患有MDS和血小板减少症的60岁男性患者的治疗进展,该患者计划接受MAC和allo-HSCT,他继续进行自行车测力计和从入院到出院的步骤练习。患者因allo-HSCT入院,在第4天,他开始在洁净室中进行自行车测力计和台阶运动,并一直持续到出院。因此,出院时维持运动耐量和下肢肌力.此外,患者能够在受限环境中继续康复,没有出现不良事件.
结论:该病例的康复和治疗过程可能为MDS合并血小板减少症患者提供有价值的信息。
BACKGROUND: In myelodysplastic syndromes (MDS), in addition to disease-related symptoms, many adverse events are associated with anticancer agents, myeloablative conditioning (MAC), and allogeneic hematopoietic stem cell transplantation (allo-HSCT). Isolation and bed rest in a clean room severely limit physical activity, resulting in cardiopulmonary and muscle weakness. In addition, post-transplant patients may experience general fatigue, gastrointestinal symptoms, and infections associated with a weakened immune system, as well as graft-versus-host disease, which causes further decline in physical function and activities of daily living (ADL). Most
reports on the rehabilitation of patients with hematopoietic tumors involve interventions before and after chemotherapy or transplantation. However, an important issue is to establish effective and feasible exercise programs in a clean room setting, where activity is severely limited and physical function is most likely to decline.
METHODS: This
case report describes the treatment progress of a 60-year-old man with MDS and thrombocytopenia scheduled to receive MAC and allo-HSCT, who continued bicycle ergometer and step exercises from admission to discharge. The patient was admitted for allo-HSCT, and on day 4, he started bicycle ergometer and step exercise in a clean room and continued until discharge. As a result, exercise tolerance and lower-extremity muscle strength were maintained at the time of hospital discharge. Furthermore, the patient was able to continue rehabilitation in a restricted environment without adverse events.
CONCLUSIONS: The rehabilitation and treatment course of this
case may provide valuable information for patients with MDS and thrombocytopenia.