Physical therapy during allogeneic hematopoietic stem cell transplantation for the treatment of aplastic anemia: a rare clinical case

Abstract

Introduction: Aplastic anemia (AA) is a rare clinical condition that develops from hematopoietic bone marrow dysfunction. The indicated treatment is hematopoietic stem cell transplantation (HSCT). Objective: To describe the clinical case and the strategies used by physical therapy during the physical rehabilitation process. Methods: This case report was carried out with a female patient, 34 years old, diagnosed with severe AA. After clinical evaluation, allogeneic HSCT from a related donor with histo-immunological compatibility was indicated. The patient remained hospitalized for 35 days. The goals of physical rehabilitation were to maintain pulmonary ventilation, prevent the accumulation of secretions, and minimize the progression of fatigue, loss of muscle strength and endurance. Results: The strategy adopted to face this extreme hematological fragility and its clinical implications avoided a significant loss in the six-minute walk test performance (-10%) at the end of hospitalization. Conclusion: The implementation of physical rehabilitation during HSCT for the treatment of AA was a real challenge, but the adopted strategy proved to be safe, well tolerated and sufficient to avoid further damage to the functional status.