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Cognition in Allogeneic Stem Cell Transplanted Patients and Sports

Not Applicable
Conditions
Exercise Intervention
Allogeneic Stem Cell Transplantation
Interventions
Behavioral: Control
Behavioral: Exercise
Registration Number
NCT02533947
Lead Sponsor
Universitätsklinikum Hamburg-Eppendorf
Brief Summary

Studies suggest that patients with hematological malignancies undergoing allogeneic hematopoietic stem cell transplantation (HSCT) are at risk for cognitive decline and long-term cognitive dysfunction. To address this issue, a randomized controlled intervention trial on the effect of physical exercise on cognition is conducted. In addition, the impact on psychological and physical health outcomes is evaluated. Results may benefit patients who suffer from disease- or treatment-associated cognitive change.

Detailed Description

Studies suggest that patients with hematological malignancies undergoing allogeneic hematopoietic stem cell transplantation (HSCT) are at risk for cognitive decline and long-term cognitive dysfunction. To address this issue, a randomized controlled intervention trial on the effect of physical exercise on cognition is conducted. In addition, the impact on psychological and physical health outcomes such as depression, fatigue, health-related quality of life and physical fitness is evaluated. A healthy control group matched to the patients on age, gender, and education will be included to both control for practice effects on neuropsychological measures and allow additional comparisons on self-report measures. The healthy control group will undergo neuropsychological testing and questionnaire survey at baseline and 4 months. Demographic data will be collected from all study participants at baseline. Medical data will be collected from patients at all time points. Results may benefit patients who suffer from disease- or treatment-associated cognitive change.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
80
Inclusion Criteria
  • hematological malignancy (AML, ALL, MDS, OMF, CML, MM, NHL, Hodgkin, AA)
  • 3 to 6 months after allogeneic HSCT
  • ≥ 18 years of age at time of transplantation
  • German as mother tongue
  • regular follow-up visits at the transplantation center during the first year after transplantation
Exclusion Criteria
  • > 75 years of age at time of transplantation
  • relapse/progress
  • thrombocyte count ≤ 50 G/l
  • GvHD with lung involvement
  • compromised lung function (patients who need oxygen)
  • compromised cardiovascular function (< 10-m walk)
  • florid infection
  • immobility
  • neurological disease
  • severe psychiatric disease
  • regular intake of psychoactive drugs or substance abuse
  • uncontrolled diabetes
  • high fracture risk
  • impaired vision and/or hearing

Healthy controls (matched for age, gender, and education):

Inclusion Criteria:

  • ≥ 18 years of age at time of enrolment
  • German as mother tongue
  • residence in the area of the transplantation center or family members/friends accompanying the patients to clinical follow-up visits

Exclusion Criteria:

  • > 75 years of age at time of enrolment
  • hematological malignancy
  • solid tumour disease
  • neurological disease
  • severe psychiatric disease
  • regular intake of psychoactive drugs or substance abuse
  • impaired vision and/or hearing

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Control groupControlA waitlist control group will get the intervention after 7 month of treatment as usual.
Exercise groupExerciseThe exercise program will be developed through a pilot phase with 10 patients prior to the start of the main study.
Primary Outcome Measures
NameTimeMethod
Change in cognitive functioning as assessed by Change in total z-scoreBaseline and 4 months

Change in total z-score derived from a neuropsychological test battery (TMT-A, TMT-B, subtests Alertness, Sustained Attention and Flexibility from the German TAP, German Version of the Rey Auditory Verbal Learning Test, Digit Span from the WAIS-IV, German Version of the COWA, Tower of London).

Secondary Outcome Measures
NameTimeMethod
Change in depressive symptomsBaseline, 4 months, 7 months

Measured with the HADS subscale depression (change in subscale score)

Change in physical ability/capability (walking ability)Baseline, 4 months, 7 months

Measured with the 6-min walk test (change in walk distance in meters)

Change in cognitive functioning as assessed by Change in total z-scoreBaseline and 7 months

Change in total z-score derived from a neuropsychological test battery (TMT-A, TMT-B, subtests Alertness, Sustained Attention and Flexibility from the German TAP, German Version of the Rey Auditory Verbal Learning Test, Digit Span from the WAIS-IV, German Version of the COWA, Tower of London).

Change in fine-motor functionBaseline, 4 months, 7 months

Change in z-score derived from the GPT dominant hand

Change in immunological functionsBaseline, 4 months, 7 months

Severity of GvHD

Change in physical fitness (muscle strength)Baseline, 4 months, 7 months

Measured with M. quadriceps isometric strength test, one 10-sec trial on each leg (change in mean strength value)

Change in self-reported physical activityBaseline, 4 months, 7 months

Measured with the EPIC Physical Activity Questionnaire

Change in fatigueBaseline, 4 months, 7 months

Measured with the MFI-20 (change in total score)

Change in anxietyBaseline, 4 months, 7 months

Measured with the HADS subscale anxiety (change in subscale score)

Change in self-reported cognitive functioning as assessed by Change in scale sum score (composite score) of the FEDA and FLei questionnairesBaseline, 4 months, 7 months

Change in scale sum score of the FEDA and FLei questionnaires measuring self-perceived attentional (FEDA scale 1: Distractibility and Retardation in Mental Processes, FEDA scale 2: Fatigue and Retardation in Activities of Daily Living, FEDA scale 3: Decrease in Drive), memory (FLei scale memory), and executive dysfunctions (FLei scale executive function).

Change in physical activity (intensity)Baseline, 7 months

Measured with accelerometry, 1-week period (change in metabolic equivalent task \[MET\] values)

Change in health-related quality of lifeBaseline, 4 months, 7 months

Measured with the EORTC QLQ-C30 (change in global health status / QoL scale)

Change in fear of cancer recurrenceBaseline, 4 months, 7 months

Measured with the PA-F12 (change in sum score)

Trial Locations

Locations (1)

University Medical Center Hamburg-Eppendorf

🇩🇪

Hamburg, Germany

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