Frailty Can Lengthen Post-Transplant Hospital Stays


Consulting physical therapy early on and speaking up to the health care team can help patients with blood cancer be more prepared for a hematopoietic stem cell transplant, an expert said.

Patients with blood cancer who are frail tend to have longer hospital stays after undergoing hematopoietic stem cell transplant, highlighting the importance of patients discussing their health with their care teams and working with doctors, such as physical therapists to improve their functioning, explained Kayla Giannetti, a nurse practitioner in the department of hematology and medical oncology at the Cleveland Clinic.

Giannetti and her team recently conducted research examining the effects of frailty — which includes components such as cognitive health, time to get up and go, falls, weight loss and others — on transplant outcomes. Findings showed that frailty did not affect a patient’s ability to undergo a transplant or their survival outcomes after the procedure, though it was associated with significantly longer hospital stays.

In an interview, Giannetti offered advice for patients who may be frail and plan to undergo a hematopoietic stem cell transplant. In short, patients should consult physical therapy early on in the process, and always be sure to speak up to their care team about questions or concerns that they have.


The main thing that I would encourage patients to really do is move … and do speak up.

If physical therapy is there, that can be consulted early on — the earlier, the better. And it sounds a little bit simplified, but … even if your goal is to get up from the bed to the chair, that makes a big difference in your overall physical health.

I tell people your psychosocial [and] your cognitive health, it's just important. So knowing when to ask questions [is also important]. Speak up if you don't understand something about your medications, that's an important thing to really have your provider, your nurse and your care team, slow down and explain it to you more deeply.

There's only something else that can be an alternative option for you in terms of having some of these things that you can't help, you're going to have nausea, you're going to have mouth sores associated with transplant, that's going to affect your nutritional deficiencies even more. And if what they're giving you for nausea is not working, tell your provider when they're rounding because there's something else. We have a palliative medicine team, who are literally symptom-management specialists, and they have other tools in their toolbox to help you get through those things to help prevent you from getting more frail or weaker than you already are [from] side effects of the treatment you've had.

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