Haematopoietic stem cell transplantation for children and young people: is there a role for prehabilitation? A scoping review

Abstract

Purpose: Prehabilitation interventions show positive outcomes for adults undergoing haematopoietic stem cell transplantation (HSCT). Their impact on paediatric populations is less clear. This scoping review describes current prehabilitation literature, intervention feasibility, and effectiveness in improving health outcomes for children following HSCT. Methods: Following the Joanna Briggs Institute methodology, a comprehensive search of databases (AHMED, CINAHL, Cochrane library, EMCARE, MEDLINE, PsycINFO, PubMed) and grey literature was conducted. Key search terms included “HSCT”, “prehabilitation” (physical functioning, nutritional status, health behaviours), “children/young people” and “health outcomes”. Data related to review aims was extracted. Results: From 134 studies, nine met inclusion criteria (three (33%) on physical functioning, six (67%) examined nutritional status, 0 health behaviours). Eight (89%) were retrospective, with one prospective providing baseline data from a RCT. Pre-HSCT muscle strength, endurance, balance, and quality of life are lower than age-matched peers. Higher pre-HSCT muscle strength (hip flexion p = 0.002) and physical function (10 m walk p = 0.004, time-to-rise-from-floor p < 0.001) correlate with improved post-HSCT recovery. Underweight (p-values 0.035–0.044) and overweight status (p-values 0.0021–0.0413) are associated with adverse clinical outcomes. Feasibility of assessment is demonstrated with no adverse events recorded. Conclusion: Initial results are promising, with a clear need for pre-HSCT assessment in clinical settings; however, no conclusions on the effectiveness of prehabilitation can be drawn. Findings emphasise the need for further research, supporting grant applications for intervention protocols.