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The purpose of this paper is to review the evidence for the role of physical rehabilitation in stem cell transplantation patients. We will also review the literature and discuss professional experiences on how rehabilitation can play a role in stem cell transplant care and survivorship. Hematopoietic stem cell transplantation (HCT) is a procedure that has evolved substantially over the years to help treat multiple conditions, particularly hematologic malignancies. HCT can be very stressful on the body and can leave patients weakened and sometimes quite debilitated. Supportive care measures have advanced to improve the quality of life and overall survival of HCT survivors. One key component of improved supportive care is gaining increased attention, and that is physical medicine and rehabilitation. Its role in HCT survivorship care is expanding, and new insight and research within the discipline have focused on fatigue, inflammation, exercise, and the development of structured rehabilitation programs to improve the musculoskeletal sequelae of transplantation. This literature review has demonstrated the utility of physical rehabilitation in HCT, its impact on cancer-related fatigue, and to outline the current state of the literature on these topics. The paper delves into a background of HCT. Cancer-related fatigue in HCT is then discussed and summarized, and the role that exercise plays in modifying such fatigue is outlined. We then outline the models and the impact that physical rehabilitation may play in HCT recipients.

Quality of life (QoL) is an important aspect of cancer survivorship. One of the most acute problems that impact survivors in many aspects of activities of daily living and compromise their QoL is the inability to return to employment following successful cancer therapy. This is most prominent among survivors after allogeneic hematopoietic stem cell transplant (allo-HSCT). More than 50% of the survivors following allo-HSCT remain unemployed one year after the procedure. This problem extends beyond the initial few years; unemployment rates among those who underwent allo-HSCT during their childhoods or adolescence have remained high. The inability to return to employment imposes a financial burden. Survivors following allo-HSCT also experience a multitude of chronic psychosocial complications that may be both contributing and consequential to the inability to return to employment. However, many transplant programs and cancer centers do not have return-to-employment programs. In this review paper, we discuss the prevalence of unemployment following allo-HSCT. We examine the psychosocial symptoms experienced by survivors and how they may affect survivors' ability to return to employment. Finally, we propose a multi-disciplinary multi-pronged occupation-focused approach to address the complex and inter-related psychosocial symptoms to help alleviate the problem.

The objective of this paper is to report a case of anti-myelin-associated glycoprotein (anti-MAG) antibody neuropathy treated with zanubrutinib, offering insight into a potential therapeutic avenue for this challenging neurological disorder. A 65-year-old male initially presented with peripheral neuropathy in the lower distal extremities. Hematologic evaluation revealed an elevated M-spike of IgM and a high MAG antibody titer. His initial titer was measured at 1:102400 on February 28, 2023. These findings were consistent with the diagnosis of Waldenström macroglobulinemia (WM) with associated anti-MAG antibody neuropathy. The patient was started on rituximab and reported a slight improvement in symptoms. However, the patient felt the efficacy of rituximab diminished with each subsequent dose. Due to this, the patient was initiated on zanubrutinib. Close monitoring of clinical symptoms and laboratory parameters was conducted to assess treatment response and potential side effects. Following zanubrutinib therapy, the patient exhibited mild improvement in neuropathic symptoms, which have stabilized, although still present. Serologic examination demonstrated a decrease in anti-MAG-antibody titer at 1:25600 in the spring of 2023 and 1:51200 in November of 2023. Patient reports increased fatigue and musculoskeletal pain. This clinical vignette highlights the outcomes of zanubrutinib in the management of anti-MAG antibody neuropathy in a patient with WM. Further research and larger clinical trials are warranted to validate these findings and establish zanubrutinib as a viable therapeutic option for this rare and often challenging neurological disorder.

Post-transplant lymphoproliferative disorder (PTLD) is a condition that is highly variable in presentation but life-threatening for post-transplant, immunosuppressed patients. Current standard management in PTLD sees the use of a chemoimmunotherapy regimen similar to the management of diffuse large B-cell lymphoma. Here, we discuss the case of a 33-year-old male with a history of renal transplant, hemodynamically stable, who presented with fevers and night sweats lasting one month. Investigations revealed multiple masses in his liver, the largest of which was biopsied and revealed diffuse large B-cell lymphoma. PTLD is an important malignancy in patients who have received immunosuppression, but the treatment is heterogeneous, based on subtype and patient status. This case, where the addition of polatuzumab to the standard rituximab, cyclophosphamide, doxorubicin, and vincristine (R-CHOP) regimen led to favorable results, demonstrates the potential for a new standard treatment regimen for this disease.