{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T17:53:49Z","timestamp":1791050029141,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:00:00Z","timestamp":1790985600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["eJHaem"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adult haematopoietic stem cell transplantation (HSCT) survivors have deficits in physical function, fatigue and quality of life that differ between autologous and allogeneic recipients. Few randomised controlled trials (RCTs) have evaluated exercise at 3 months or more, and immune reconstitution is rarely assessed. We synthesised RCT evidence on longer\u2010term exercise effects across physical, psychosocial and immunometabolic outcomes by transplant type.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA 2020, six databases were searched (2019\u20132026) for RCTs comparing structured exercise with usual care or control in adults after HSCT, with outcomes at 3 months or more. Screening, extraction and risk\u2010of\u2010bias appraisal (Cochrane RoB 2) were conducted independently by two reviewers. Heterogeneity precluded meta\u2010analysis; findings were synthesised narratively with GRADE certainty ratings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seven RCTs (529 participants; two allogeneic, two autologous and three mixed) reported no serious exercise\u2010related adverse events. Between\u2010group 6\u2010min walk distance improved by approximately 51\u201363\u00a0m (significant in the largest trial) and sit\u2010to\u2010stand by 2.5\u20133.8 repetitions. Cardiorespiratory fitness, fatigue and quality\u2010of\u2010life effects were inconsistent, often within\u2010group only. Benefit appeared larger in allogeneic recipients, whereas an autologous trial showed none. Immunometabolic data from two trials showed an exploratory reduction in soluble ICAM\u20101 and within\u2010group recovery of body cell mass. Certainty was low to very low.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Exercise appears safe after HSCT and may improve objective physical function, with the greatest benefits observed in allogeneic and more impaired recipients. Cardiorespiratory, fatigue and quality\u2010of\u2010life effects remain uncertain, and immunometabolic evidence is preliminary. Future trials should report outcomes by transplant type and incorporate immune and metabolic endpoints with longer follow\u2010ups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>The authors confirm that clinical trial registration is not needed for this submission<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jha2.70420","type":"journal-article","created":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T17:30:10Z","timestamp":1791048610000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010Term Outcomes of Exercise\u2010Based Rehabilitation and Immunometabolic Parameters in Adult Haematopoietic Stem Cell Transplant Recipients: An Updated Systematic Review of Randomised Controlled Trials"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2935-8184","authenticated-orcid":false,"given":"Derek Dale","family":"Bayquen","sequence":"first","affiliation":[{"name":"Faculty of Health and Wellbeing University of Winchester  Winchester UK"},{"name":"The Royal Marsden NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2683-4244","authenticated-orcid":false,"given":"Prahalad","family":"Narasimhan","sequence":"additional","affiliation":[{"name":"Faculty of Health and Wellbeing University of Winchester  Winchester 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