Improve Outcomes for Older Allogeneic Transplant Recipients

This is an interventional pilot study to determine whether implementation of a supervised exercise program can improve outcomes in subjects undergoing allogeneic HCT. The primary objective is to determine feasibility. Up to 60-72 evaluable subjects will be enrolled. Evaluable subjects are defined as those participating in the exercise intervention.

Pre-frail and frail subjects will attend at least twice weekly exercise sessions with a physical therapist and be given an exercise program to complete at home prior to admission for HCT. Patients enrolled in this cohort can continue on to Cohort B.

All patients 60 years and older upon discharge from their initial hospital stay for HCT will attend at least weekly exercise sessions with a physical therapist and be given an exercise program to complete at home with sessions continued through Day +100 after HCT.

Pre-frail and frail potential HCT recipients 60 years and older will participate in a supervised exercise program from the time of enrollment up until HCT admission. Exercise compliance will be measured in part through physical activity trackers.from time of discharge from HCT until day +100 post-HCT. All HCT recipients 60 years and older will participate in a supervised exercise program from the time of discharge from HCT admission until day +100 post-HCT. Exercise compliance will be measured in part through physical activity trackers.

All HCT recipients 60 years and older will participate in a supervised exercise program from the time of discharge from HCT admission until day +100 post-HCT. Exercise compliance will be measured in part through physical activity trackers.

From date of randomization until the date of first documented discharge from the hospital, assessed up to 100 months

Inclusion Criteria: Cohort A (Prehab) Age 60 years or older. Planned allogeneic HCT in the next 1-6 months. Hematological malignancy as the indication for HCT. Pre-frail or frail by Fried frailty phenotype. Cohort B (Rehab) Age 60 years or older. Planned allogeneic HCT or HCT within the last 30 days. Hematological malignancy as the indication for HCT. Exclusion Criteria: Cohorts A and B 1. Comorbid disability or illness that prevents safe exercise.