{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T23:39:43Z","timestamp":1784763583990,"version":"3.55.0"},"reference-count":51,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T00:00:00Z","timestamp":1682553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009717","name":"Eastern Health Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100009717","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Autologous stem cell transplant is a common procedure for people with haematological malignancies. While effective at improving survival, autologous stem cell transplant recipients may have a lengthy hospital admission and experience debilitating side-effects such as fatigue, pain and deconditioning that may prolong recovery. Prehabilitation comprising exercise and nutrition intervention before stem cell transplant aims to optimise physical capacity before the procedure to enhance functional recovery after transplant. However, few studies have evaluated prehabilitation in this setting. We aim to explore preliminary efficacy of improving physical capacity of prehabilitation for people undergoing autologous stem cell transplant.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>The PIRATE study is a single-blinded, parallel two-armed pilot randomised trial of multidisciplinary prehabilitation delivered prior to autologous stem cell transplantation. Twenty-two patients with haematological malignancy waitlisted for transplant will be recruited from a tertiary haematology unit. The intervention will include up to 8 weeks of twice-weekly, supervised tailored exercise and fortnightly nutrition education delivered via phone, in the lead up to autologous stem cell transplant. Blinded assessments will be completed at week 13, approximately 4 weeks after transplant and health service measures collected at week 25 approximately 12 weeks after transplant. The primary outcome is to assess changes in physical capacity using the 6-minute walk test. Secondary measures are time to engraftment, C-reactive protein, physical activity (accelerometer), grip strength, health-related quality of life (EORTC QLQ-C30 and HDC29 supplement), self-efficacy and recording of adverse events. Health service data including hospital length of stay, hospital readmissions, emergency department presentations and urgent symptom clinic presentation at will also be recorded.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Discussion<\/jats:title>\n<jats:p>This trial will inform design of a future definitive randomised controlled trial and implementation of prehabilitation for people receiving autologous stem cell transplant by providing data on efficacy and safety.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Trial registration<\/jats:title>\n<jats:p>The PIRATE Trial has been approved by the Eastern Health Human Research Ethics Committee (E20\/003\/61055) and is funded by the Eastern Health Foundation. This trial is registered with the Australian New Zealand Clinical Trials Registry <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.anzctr.org.au\/ACTRN12620000496910\" xlink:type=\"simple\">ACTRN12620000496910<\/jats:ext-link>. Registered April 20, 2020.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0277760","type":"journal-article","created":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T17:55:05Z","timestamp":1682618105000},"page":"e0277760","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Prehabilitation to improve outcomes afteR Autologous sTem cEll transplantation (PIRATE): A pilot randomised controlled trial protocol"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4690-7949","authenticated-orcid":true,"given":"Amy M.","family":"Dennett","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7535-1919","authenticated-orcid":true,"given":"Judi","family":"Porter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen B.","family":"Ting","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas F.","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,4,27]]},"reference":[{"key":"pone.0277760.ref001","doi-asserted-by":"crossref","first-page":"619","DOI":"10.3109\/07853890.2014.952662","article-title":"Autologous hematopoietic cell transplantation: An update for clinicians","volume":"46","author":"M. Hamadani","year":"2014","journal-title":"Ann Med"},{"key":"pone.0277760.ref002","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1038\/bmt.2012.258","article-title":"Surviving the cure: long term followup of hematopoietic cell transplant recipients","volume":"48","author":"NS Majhail","year":"2013","journal-title":"Bone Marrow Transplant"},{"key":"pone.0277760.ref003","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1038\/bmt.2016.18","article-title":"Hematopoietic stem cell transplantation activity worldwide in 2012 and a SWOT analysis of the Worldwide Network for Blood and Marrow Transplantation Group including the global survey.","volume":"51","author":"D Niederwieser","year":"2016","journal-title":"Bone marrow Transplant"},{"key":"pone.0277760.ref004","doi-asserted-by":"crossref","first-page":"2447","DOI":"10.1007\/s00520-015-2744-3","article-title":"The role of physical rehabilitation in stem cell transplantation patients","volume":"23","author":"A Steinberg","year":"2015","journal-title":"Support Care Cancer"},{"key":"pone.0277760.ref005","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1038\/sj.bmt.1705624","article-title":"Experience of severe fatigue in long-term survivors of stem cell transplantation","volume":"39","author":"MF Gielissen","year":"2007","journal-title":"Bone Marrow Transplant"},{"key":"pone.0277760.ref006","doi-asserted-by":"crossref","first-page":"3746","DOI":"10.1200\/JCO.2012.42.3038","article-title":"Delivering care to long-term adult survivors of hematopoietic cell transplantation","volume":"30","author":"KL Syrjala","year":"2012","journal-title":"J Clin Oncol"},{"key":"pone.0277760.ref007","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1016\/j.apmr.2012.08.219","article-title":"Return to primary service among bone marrow transplant rehabilitation inpatients: an index for predicting outcomes","volume":"94","author":"JB Fu","year":"2013","journal-title":"Arch Phys Med Rehab"},{"key":"pone.0277760.ref008","doi-asserted-by":"crossref","first-page":"2375","DOI":"10.1249\/MSS.0000000000002116","article-title":"Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable","volume":"51","author":"KL Campbell","year":"2019","journal-title":"Med Sci Sports Exerc"},{"key":"pone.0277760.ref009","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1038\/bmt.2009.27","article-title":"A randomized trial on the effect of a multimodal intervention on physical capacity, functional performance and quality of life in adult patients undergoing allogeneic SCT","volume":"43","author":"M Jarden","year":"2009","journal-title":"Bone Marrow Transplant"},{"key":"pone.0277760.ref010","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1093\/jjco\/hyy144","article-title":"Exercise for physical fitness, fatigue and quality of life of patients undergoing hematopoietic stem cell transplantation: a meta-analysis of randomized controlled trials","volume":"48","author":"Y Liang","year":"2018","journal-title":"Jpn J Clin Oncol"},{"key":"pone.0277760.ref011","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1007\/s11764-019-00775-9","article-title":"Long-term effectiveness and cost-effectiveness of an 18-week supervised exercise program in patients treated with autologous stem cell transplantation: results from the EXIST study","volume":"13","author":"JM van Dongen","year":"2019","journal-title":"J Cancer Surviv"},{"key":"pone.0277760.ref012","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1007\/s00520-012-1698-y","article-title":"Changes in nutritional status, body composition, quality of life, and physical activity levels of cancer patients undergoing autologous peripheral blood stem cell transplantation","volume":"21","author":"YC Hung","year":"2013","journal-title":"Support Care Cancer"},{"key":"pone.0277760.ref013","first-page":"CD002920","article-title":"Nutrition support for bone marrow transplant patients","volume":"3","author":"SM Murray","year":"2017","journal-title":"Cochrane Database Syst. Rev"},{"key":"pone.0277760.ref014","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1016\/j.clnu.2014.06.006","article-title":"Implementation of an evidenced based nutrition support pathway for haematopoietic progenitor cell transplant patients","volume":"34","author":"S Andersen","year":"2015","journal-title":"Clin Nutr"},{"key":"pone.0277760.ref015","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1007\/s00520-018-4384-x","article-title":"Implementing and sustaining an evidence-based nutrition service in a haematology unit for autologous stem cell transplant patients","volume":"27","author":"L Atkins","year":"2019","journal-title":"Support Care Cancer"},{"key":"pone.0277760.ref016","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1016\/j.nut.2010.11.010","article-title":"Multidisciplinary nutritional support for autologous hematopoietic stem cell transplantation: a cost-benefit analysis","volume":"27","author":"S Hagiwara","year":"2011","journal-title":"Nutrition"},{"key":"pone.0277760.ref017","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1038\/bmt.2014.52","article-title":"Telephone-delivered nutrition and exercise counselling after auto-SCT: a pilot, randomised controlled trial","volume":"49","author":"YC Hung","year":"2014","journal-title":"Bone Marrow Transplant"},{"key":"pone.0277760.ref018","doi-asserted-by":"crossref","first-page":"e13023","DOI":"10.1111\/ecc.13023","article-title":"Prehabilitation for adults diagnosed with cancer: A systematic review of long-term physical function, nutrition and patient-reported outcomes","volume":"28","author":"S Faithfull","year":"2019","journal-title":"Eur J Cancer Care"},{"key":"pone.0277760.ref019","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1007\/s00520-011-1156-2","article-title":"Impaired physiological function and health-related QOL in patients before hematopoietic stem-cell transplantation","volume":"20","author":"S Morishita","year":"2012","journal-title":"Support Care Cancer"},{"issue":"1","key":"pone.0277760.ref020","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1186\/s13104-021-05591-y","article-title":"Multiple myeloma and physical activity.","volume":"14","author":"CSY Lecat","year":"2021","journal-title":"BMC Res Notes"},{"key":"pone.0277760.ref021","doi-asserted-by":"crossref","first-page":"3383","DOI":"10.1182\/blood-2008-07-170746","article-title":"Long-term outcome of patients with multiple myeloma after autologous hematopoietic cell transplantation and nonmyeloablative allografting","volume":"113","author":"M Rotta","year":"2009","journal-title":"Blood"},{"issue":"24","key":"pone.0277760.ref022","doi-asserted-by":"crossref","first-page":"5814","DOI":"10.1200\/JCO.2005.01.230","article-title":"Riding the crest of the teachable moment: promoting long-term health after the diagnosis of cancer","volume":"23","author":"W Demark-Wahnefried","year":"2005","journal-title":"J Clin Oncol"},{"issue":"1","key":"pone.0277760.ref023","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s40140-022-00516-2","article-title":"From theory to practice: an international approach to establishing prehabilitation programmes.","volume":"12","author":"JF Davis","year":"2022","journal-title":"Curr Anesthesiol Reps"},{"key":"pone.0277760.ref024","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1080\/09593985.2018.1423655","article-title":"Physical exercise prior to hematopoietic stem cell transplantation: A feasibility study","volume":"34","author":"I van Haren","year":"2018","journal-title":"Physiother Theory Pract"},{"key":"pone.0277760.ref025","doi-asserted-by":"crossref","first-page":"i5239","DOI":"10.1136\/bmj.i5239","article-title":"CONSORT 2010 statement: extension to randomised pilot and feasibility trials","volume":"355","author":"SM Eldridge","year":"2016","journal-title":"BMJ"},{"key":"pone.0277760.ref026","doi-asserted-by":"crossref","first-page":"e433","DOI":"10.1016\/S1470-2045(18)30599-0","article-title":"Exercise as part of routine cancer care","volume":"19","author":"D Santa-Mina","year":"2018","journal-title":"Lancet Oncol"},{"key":"pone.0277760.ref027","article-title":"American College of Sports Medicine, Exercise is Medicine","year":"2019","journal-title":"Being Active When You Have Cancer"},{"key":"pone.0277760.ref028","article-title":"American College of Sports Medicine, Exercise is Medicine","year":"2019","journal-title":"Sit Less, Move More."},{"key":"pone.0277760.ref029","article-title":"American College of Sports Medicine, Exercise is Medicine","year":"2019","journal-title":"Moving Through Cancer"},{"key":"pone.0277760.ref030","volume-title":"World alliance for patient safety: WHO draft guidelines for adverse event reporting and learning systems: from information to action","author":"World Health Organisation","year":"2005"},{"key":"pone.0277760.ref031","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1097\/01.MLR.0000062554.74615.4C","article-title":"Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation","volume":"41","author":"GR Norman","year":"2003","journal-title":"Med Care"},{"key":"pone.0277760.ref032","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1055\/s-0032-1323746","article-title":"Validity of the six-minute walk test in cancer patients","volume":"34","author":"K Schmidt","year":"2013","journal-title":"Int J Sports Med"},{"issue":"2","key":"pone.0277760.ref033","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.jclinepi.2012.09.002","article-title":"Sample size calculations for pilot randomized trials: a confidence interval approach.","volume":"66","author":"K Cocks","year":"2013","journal-title":"J Clin Epidemiol"},{"key":"pone.0277760.ref034","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.jphys.2018.08.003","article-title":"Motivational interviewing added to oncology rehabilitation did not improve moderate-intensity physical activity in cancer survivors: a randomised trial","volume":"64","author":"AM Dennett","year":"2018","journal-title":"J Physiother"},{"issue":"7139","key":"pone.0277760.ref035","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1136\/bmj.316.7139.1236","article-title":"What\u2019s wrong with Bonferroni adjustments","volume":"316","author":"TV Perneger","year":"1998","journal-title":"BMJ"},{"key":"pone.0277760.ref036","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1123\/jpah.8.1.45","article-title":"Determination of step rate thresholds corresponding to physical activity intensity classifications in adults","volume":"8","author":"M Abel","year":"2011","journal-title":"J Phys Act Health"},{"key":"pone.0277760.ref037","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/j.soncn.2007.08.002","article-title":"Physical activity and cancer control","volume":"23","author":"KS Courneya","year":"2007","journal-title":"Semin Oncol Nurs"},{"key":"pone.0277760.ref038","doi-asserted-by":"crossref","first-page":"e515","DOI":"10.1111\/ajco.12642","article-title":"Exercise therapy in oncology rehabilitation in Australia: A mixed-methods study","volume":"13","author":"AM Dennett","year":"2017","journal-title":"Asia Pac J Clin Oncol"},{"issue":"Cd012020","key":"pone.0277760.ref039","article-title":"Preoperative exercise training for patients with non-small cell lung cancer","volume":"6","author":"V Cavalheri","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"pone.0277760.ref040","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1007\/s10198-017-0936-0","article-title":"Cost-utility and cost-effectiveness of physical exercise during adjuvant chemotherapy.","volume":"19","author":"H van Waart","year":"2018","journal-title":"Eur J Health Econ"},{"key":"pone.0277760.ref041","article-title":"National Library of Medicine, ClinicalTrials.gov","author":"National Institutes of Health,U.S","year":"2020","journal-title":"Impact of Prehabilitation in Oncology Via Exercise- Bone Marrow Transplant (IMPROVE-BMT)."},{"key":"pone.0277760.ref042","author":"National Institutes of Health, U.S","year":"2020","journal-title":"National Library of Medicine, ClinicalTrials.govFeasibility of Pre-Transplant Exercise (Pre-habilitation) for Multiple Myeloma Patients Awaiting Autologous Stem Cell Transplantation"},{"key":"pone.0277760.ref043","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1097\/ALN.0000000000000393","article-title":"Prehabilitation versus rehabilitation: a randomized control trial in patients undergoing colorectal resection for cancer","volume":"121","author":"C Gillis","year":"2014","journal-title":"Anesthesiology"},{"key":"pone.0277760.ref044","doi-asserted-by":"crossref","first-page":"S247","DOI":"10.1016\/S0261-5614(14)50648-6","article-title":"Effects of preoperative use of an immune-enhancing diet on postoperative complications and long-term outcome: a randomized clinical trial in colorectal cancer surgery in Japanese patients","volume":"33","author":"T Moriya","year":"2014","journal-title":"Clin Nutr"},{"key":"pone.0277760.ref045","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1093\/ajcn\/73.2.323","article-title":"Effect of perioperative nutrition, with and without arginine supplementation, on nutritional status, immune function, postoperative morbidity, and survival in severely malnourished head and neck cancer patients","volume":"73","author":"MA van Bokhorst-De Van Der Schueren","year":"2001","journal-title":"Am J Clin Nutr"},{"key":"pone.0277760.ref046","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1007\/s00464-012-2560-5","article-title":"Impact of a trimodal prehabilitation program on functional recovery after colorectal cancer surgery: a pilot study","volume":"27","author":"C Li","year":"2013","journal-title":"Surg Endosc"},{"key":"pone.0277760.ref047","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1097\/DCR.0000000000000987","article-title":"Multimodal prehabilitation programs as a bundle of care in gastrointestinal cancer surgery: a systematic review","volume":"61","author":"V Bolshinsky","year":"2018","journal-title":"Dis Colon Rectum"},{"key":"pone.0277760.ref048","doi-asserted-by":"crossref","first-page":"e11","DOI":"10.2196\/jmir.6575","article-title":"Cancer survivors\u2019 experience with telehealth: a systematic review and thematic synthesis","volume":"19","author":"A Cox","year":"2017","journal-title":"J Med Internet Res"},{"key":"pone.0277760.ref049","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1001\/jamaoncol.2019.0011","article-title":"Effect of collaborative telerehabilitation on functional impairment and pain among patients with advanced-stage cancer: a randomized clinical trial","volume":"5","author":"AL Cheville","year":"2019","journal-title":"JAMA Oncol"},{"key":"pone.0277760.ref050","volume-title":"Clinical practice guidelines for teleoncology.","author":"COSA Teleoncology Guidelines Working Group","year":"2016"},{"key":"pone.0277760.ref051","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1200\/OP.20.00210","article-title":"Keeping patients with cancer exercising in the age of COVID-19.","volume":"10","author":"RU Newton","year":"2020","journal-title":"JCO Oncology Practice."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0277760","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T17:55:46Z","timestamp":1682618146000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0277760"}},"subtitle":[],"editor":[{"given":"Dario","family":"Ummarino","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,4,27]]},"references-count":51,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4,27]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0277760","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,27]]}}}