An Individual Rehabilitation Project in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation

Background Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative option for various hematological diseases but often leads to physical deconditioning, fatigue, and reduced quality of life (QoL). Rehabilitation, through therapeutic exercise (TE), may counteract these complications. This study evaluated the feasibility and safety (clinical effects as secondary aims) of an Individual Rehabilitation Project (IRP) integrating TE during hospitalization and post-discharge in patients after allo-HSCT. Methods Prospective longitudinal, uncontrolled study conducted at [blinded for review] . The IRP comprised six weekly supervised TE sessions during hospitalization and a personalized post-discharge exercise plan. Functional independence (Barthel Index), fatigue (Fatigue Severity Scale), aerobic/anaerobic fitness (6-Minute Walk Test, 30-Second Sit-to-Stand Test), and perceived exertion (Modified Borg Scale) were assessed at baseline (T1), discharge (T2), 100 days (T3), and 6 months post-transplant (T4). Repeated measures ANOVA with Bonferroni corrections analyzed temporal changes. Results Forty-seven patients were enrolled, and 33 completed the study. All survivors at 180 days completed the IRP without adverse events (CTCAE v5.0). Significant changes over time were observed for fatigue (p=0.001), 6-Minute Walk Test (p=0.007), 30-Second Sit-to-Stand Test (p<0.001), and Borg Scale (p=0.007), whereas the Barthel Index remained stable (p=0.430). Fatigue and perceived exertion increased significantly at discharge and subsequently improved, while functional performance declined in the early post-transplant phase and recovered progressively by T4. Conclusions The IRP integrating TE was feasible, safe, and associated with reduced fatigue and improved physical capacity after allo-HSCT. Although limited by the lack of a control group, these findings support structured rehabilitation in this population.