1000 Section - Improving frailty through exercise-based tele-prehabilitation for adults undergoing Allogeneic Hematopoietic Cell Transplantation (allo-HCT): a real-world observational study

Tuesday, May 19, 2026

6:00 PM - 7:30 PM PT

Co-Author(s)

Raquel S. Salinas González, N/A, MD (she/her/hers)

PM&R Physician
Hospital Clínic de Barcelona
Barcelona, Catalonia, Spain

Presenting Author/Autor expositor(s)

SO

Sonia Ortiz, PT

Physiotherapist
Physical Medicine and Rehabilitation Department. Hospital Clínic de Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain

Co-Author/Coautor(s)

DS

Daniela Salinas-Camacho, MLS

Medical Laboratory Scientist
Hematology Department. Massachusetts General Hospital, Boston, MA.
Boston, Massachusetts, United States
LG

Laia Guardia, BSN

Nurse (IPA)
Hematopoietic Transplantation Unit, Hematology Department, Institute of Cancer and Blood Diseases (ICAMS), Hospital Clínic de Barcelona, Barcelona, Spain.
Barcelona, Catalonia, Spain
BS

Berta Solé, BSN

Nurse
Hematopoietic Transplantation Unit, Hematology Department, Institute of Cancer and Blood Diseases (ICAMS), Hospital Clínic de Barcelona, Barcelona, Spain.
Barcelona, Catalonia, Spain
CM

Cristina Moreno, BSN

Nurse
Hematopoietic Transplantation Unit, Hematology Department, Institute of Cancer and Blood Diseases (ICAMS), Hospital Clínic de Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain
MS

María Suárez-Lledó, MD

Hematologist
Hematopoietic Transplantation Unit, Hematology Department, Institute of Cancer and Blood Diseases (ICAMS), Hospital Clínic de Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain
LR

Laura , Rosiñol, MD

Hematologist
Hematopoietic Transplantation Unit, Hematology Department, Institute of Cancer and Blood Diseases (ICAMS), Hospital Clínic de Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain
CC

Concepción Closa, MD, PhD

PM&R Physician
Physical Medicine and Rehabilitation Department. Hospital Clínic de Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain
CM

Carmen Martínez, MD, PhD

Hematologist
Hematopoietic Transplantation Unit, Hematology Department, Institute of Cancer and Blood Diseases (ICAMS), Hospital Clínic de Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain
FF

Francesc Fernández-Avilés, MD, PhD

Hematologist
Hematopoietic Transplantation Unit, Hematology Department, Institute of Cancer and Blood Diseases (ICAMS), Hospital Clínic de Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain
MR

Montserrat Rovira, MD, PhD

Hematologist
Hematopoietic Transplantation Unit, Hematology Department, Institute of Cancer and Blood Diseases (ICAMS), Hospital Clínic de Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain
RS

Raquel Sebio, PT, PhD

Physiotherapist
Physical Medicine and Rehabilitation Department. Hospital Clínic de Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain
MS

María Queralt Salas, MD, PhD

Hematologist
Hematopoietic Transplantation Unit, Hematology Department, Institute of Cancer and Blood Diseases (ICAMS), Hospital Clínic de Barcelona, Barcelona, Spain
Barcelona, Catalonia, Spain

Objectives : Frailty syndrome has a prevalence of up to 35% in patients eligible for allogeneic hematopoietic cell transplantation (allo-HCT) and is associated with increased post-transplant mortality. Since 2023, our center implemented a comprehensive frailty program, incorporating multidisciplinary assessment and exercise-based tele-prehabilitation prior to allo-HCT.

Objective: To reduce the incidence of frailty prior to allo-HSCT through a exercise-based tele-prehabilitation program.

Design: We conducted a single-center, prospective longitudinal study to evaluate the impact of an exercise-based teleprehabilitation intervention within a structured Frailty Program (FP). Frailty was assessed using the HCT Frailty Scale (HCT-FS) at initial consultation and hospital admission. Patients were grouped into three cohorts based on enrollment period: No-Prehab (April 2021–June 2022), Pilot-Prehab (June 2022–October 2023), and Teleprehabilitation (from November 2023 onward).Primary endpoints included frailty status at admission, adherence, and prehabilitation-related adverse events. Descriptive statistics and subgroup differences were analyzed using counts, percentages, Chi-square, and Mann-Whitney U tests. One-year post-transplant outcomes, including overall survival (OS) and non-relapse mortality (NRM), were analyzed using Kaplan-Meier and univariate regression; P< 0.05 was considered significant.

Results: The Tele-Prehab cohort included 50 patients and was compared with No-Prehab (n=76) and Pilot-Prehab (n=59) cohorts. Prehabilitation significantly reduced frailty at hospital admission, particularly in the Tele-Prehab cohort compared with No-Prehab (P< 0.001). The intervention was feasible, safe, and achieved consistently high adherence across frailty groups (76–88%) with no exercise-related adverse events. Frail patients had lower overall survival (OS) than pre-frail and fit patients (P< 0.001), while OS and non-relapse mortality (NRM) were similar across prehabilitation cohorts.

Conclusion: Frailty, as a dynamic condition, can be managed and optimized through exercise-based tele-prehabilitation prior to allo-HCT, representing a safe and feasible approach for these patients.