Ann Rehabil Med.  2017 Jun;41(3):456-464. 10.5535/arm.2017.41.3.456.

Cardiopulmonary Exercise Test in Leukemia Patients After Chemotherapy: A Feasibility Study

• Kim S
• Song IC
• Jee S

• KMID: 2389462
• DOI: http://doi.org/10.5535/arm.2017.41.3.456

Abstract

OBJECTIVE
To explore the feasibility of cardiopulmonary exercise test (CPET) in leukemia patients after chemotherapy.
METHODS
Leukemia patients with histologically confirmed hematologic malignancies were reviewed. We evaluated for CPET, between receiving chemotherapy and undergoing stem cell transplantation after 2 weeks. We recorded exercise testing and physiologic parameters during CPET between January 2013 to May 2015. All patients were subjected to symptoms limited to exercise testing, according to the Modified Bruce Protocol. We considered that if respiratory exchange ratio achieved was over 1.10, participants had successfully completed CPET. We dichotomized all participants into two groups (normal group, normal range of resting heart rate; higher group, over 100 per minute of heart rate).
RESULTS
30 patients were finally enrolled. All participants had no adverse effects during the exercise test. Mean peak double product was 26,998.60 mmHg·beats/min (range, 15,481-41,004), and mean peak oxygen consumption (VOâ‚‚ peak) was 22.52±4.56 mL/kg/min. Significant differences were observed in the normal group with VOâ‚‚ peak (mean, 24.21 mL/kg/min; p=0.027) and number of prior intensive chemotherapy, compared to the higher group (mean, 1.95; p=0.006).
CONCLUSION
Our results indicate that CPET in leukemia patients before stem cell transplantation was very safe, and is an efficient method to screen for patients with poor cardiac functions. As CPET presents the parameters which reveal the cardiopulmonary functions, including VOâ‚‚ peak, double product and exercise capacity, this exercise test would help to predict the physical performance or general condition of the leukemia patients.

Keyword

Exercise test; Leukemia; Feasibility studies; Rehabilitation; Tachycardia

MeSH Terms

Drug Therapy*
Exercise Test*
Feasibility Studies*
Heart
Heart Rate
Hematologic Neoplasms
Humans
Leukemia*
Methods
Oxygen Consumption
Reference Values
Rehabilitation
Stem Cell Transplantation
Tachycardia

Figure

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  Fig. 1 Cardiopulmonary exercise test facilities with 12-lead ECG monitoring (ST80i Stress Testing System, Philips Medical System, Andover, MA,USA).

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  Fig. 2 Flow chart for determining study participants. CPET, cardiopulmonary exercise test.

• 

  Fig. 3 The mean number of prior intensive chemotherapy. HR, heart rate.

• 

  Fig. 4 The mean peak oxygen consumption. HR, heart rate.

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