SOMATIC RISK-FACTORS FOR INTERMEDIATE AND LONG-TERM SEQUELAE AFTER HEMATOLOGICAL STEM-CELL THERAPY PREDICTIVE FOR FEASIBILITY OF A REHABILITATION PROGRAM

Background: Hematological stem cell therapy (HSCT) is a major approach with a curative potential for several hematologic malignancies and pe rhaps also for solid tumors. Up to now there is almost no experience a bout the feasibility, efficacy or cost effectiveness of rehabilitation al efforts after HSCT. Moreover, no data exist about possible risk fac tors, which might have a predictive value of the outcome of those stra tegies. Patients and Methods: Between 1993-1997, a total of 207 patien ts were included into a structured 4-6 weeks rehabilitation program af ter allogenic pr autologous HSCT. All medical and transplantation data were stored by online electronic data processing (EDP) and analyzed f or subgroup characteristics and risk factors. Furthermore, odds ratios were calculated. Results: We found life-threatening infections, trans fusion dependency, myopathy, osteoporosis with fractures and hemorrhag ic cystitis as dependend from transplantation procedures and the devel opment of GvHD. 88% of patients were able to complete the entire rehab ilitation program. 45% of patients who received allogenic HSCT and 44% who had autologous HSCT did improve significantly as measured by Karn ofsky Index. However, severe complications predominantly in patients w ho had received allogenic, especially VUD-HSCT, demand intensive coope ration with the entire facilities of a transplant center. Conclusions: Prospective studies should be initiated to address the question of po tential benefit and cost effectiveness of rehabilitational programs co mpared to medical surveillance alone.