Physical Activity and Sleep Measures Using a Fitness Tracking Device during Hematopoietic Cell Transplantation: A Pilot Study

Abstract Patients undergoing hematopoietic cell transplantation (HCT) experience decline in their physical activity during their transplant admission. There is limited experience with prospective monitoring of transplant recipients. We therefore measured physical activity and sleep patterns of subjects undergoing autologous and allogeneic HCT. Eighty-three patients were consented for this study. Sixty-three patients competed the study and had their physical activity prospectively assessed using the fitness-tracking device Fitbit HR®. Outcomes included adherence, physical activity, readmission, hematopoietic engraftment, and 100-day survival. Sixty percent of patients (n=37) underwent autologous HCT and 40% (n=26) underwent allogenic HCT. Both groups had a comparable number of steps at admission to the hospital. The number of daily steps during the study period was lower in the allogeneic group (2,159 vs 3,008, p=0.07), as was the minimum number of steps recorded over the transplant admission (allogeneic HCT = 395 vs autologous HCT = 848, p=0.01). Patients undergoing allogeneic HCT were less active on the day prior to discharge (1,956 steps vs. 3,183 steps, p=0.08). In multivariate analysis, physical activity was not associated with HCT-related outcomes. Patients undergoing HCT experience significant decline in their physical activity during their transplant admission that does not recover by the time of discharge. This effect can be objectively measured using fitness tracking devices. Extended Abstract Introduction: Patients undergoing hematopoietic cell transplantation (HCT) experience decline in their physical activity during their transplant admission. There is limited experience with prospective monitoring of transplant recipients. We therefore measured physical activity and sleep patterns of subjects undergoing autologous and allogeneic HCT using fitness-tracking device Fitbit HR®. Methods: Eighty-three patients were consented for this study. Sixty-three patients competed the study and had their physical activity prospectively assessed using Fitbit HR®. Outcomes included adherence, physical activity, readmission, hematopoietic engraftment, and 100-day survival. Results: Sixty percent of patients (n=37) underwent autologous HCT and 40% (n=26) underwent allogenic HCT. Adherence to the fitness-tracking device was 76% throughout hospitalization. Both groups had a comparable number of steps at admission to the hospital. The number of daily steps during the study period was lower in the allogeneic group (2,159 vs 3,008, p=0.07), as was the minimum number of steps recorded over the transplant admission (allogeneic HCT = 395 vs autologous HCT = 848, p=0.01). Patients undergoing allogeneic HCT were less active on the day prior to discharge (1,956 steps vs. 3,183 steps, p=0.08). In multivariate analysis, physical activity was not associated with HCT-related outcomes. Sleep was significantly impacted in patients admitted for transplant with a median of 4.5 interruption of sleep per night. Conclusion: Patients undergoing HCT experience significant decline in their physical activity during their transplant admission that does not recover by the time of discharge. This effect can be objectively measured using fitness tracking devices.