EDISCIENCES

ABSTRACT

Background: Rehabilitation for patients with hematological malignancies undergoing allogeneic hematopoietic stem cell transplantation (AlloHSCT) addressesphysicalandpsychosocialdeficitsbefore,during,andafterhospitalization. However, marked heterogeneity in study designs, interventions, outcomes, and measurement methods complicates evidence synthesis, resulting in uncertainty regarding optimal treatment prescriptions and clinical implications. In this study, we aimed to develop a standardized measurement guideline for rehabilitative intervention studies in AlloHSCT patients to reduce clinical diversity and improve evidence synthesis. Method: A scoping review preceded a two-round online Delphi consensus process, and a multidisciplinary Steering Committee oversaw the study. Panelists included corresponding authors from included studies in the scoping review, recent gray literature authors, and health professionals from transplant units worldwide. Invitations were sent to 214 experts, with 24 (11%) participating. Consensus was defined as ≥67% agreement on a five-point Likert scale. Proposals for measurement guideline components (scope (i.e., target population and setting), outcomes, instruments and number and timing of measurements) were evaluated, with panelists providing comments to refine their recommendations. Results: Panelists agreed on defining measurement guidelines for two settings: hospital (during transplant hospitalization) and non-hospital (before or after hospitalization). Consensus was reached on specifying both outcomes and measurement instruments (acceptance rate 79%), as well as on including a minimum number of measurements with specified time points (acceptance rate 88%). For hospital studies, measurements were recommended at “baseline” and “once discharge criteria are met”; in non-hospital studies, measurements were recommended at “baseline,” “last day of pre-rehabilitation,” and “one year after transplantation” (for rehabilitation studies only). “Strength” should be measured via Handgrip Dynamometer and a 30 s Sit-to-Stand test, and “exercise capacity” via the 6 min Walk Test. Conclusions: This Delphi study generated the first consensus-based measurement guideline for rehabilitative interventions in patients with hematological malignancies treated with AlloHSCT, specifying outcomes, instruments, and timing for both hospital and non-hospital settings. While the measurement guideline is expected to reduce clinical diversity and facilitate robust meta-analyses, future research should expand its scope to include patient reported outcomes, ensuring greater relevance to patient priorities and needs.