Physical Recovery After CAR-T Cell Therapy vs. Autologous Stem Cell Transplantation Assessed Through Quantitative Rehabilitation Measures
Abstract
1. Introduction
2. Methods
2.1. Patient Population
2.2. Objective Assessment Tools
- Muscle Strength Testing. Manual muscle testing was performed for major muscle groups considered critical for functional mobility and independence, including hip flexors, knee extensors, ankle dorsiflexors, shoulder abductors, and elbow flexors. Strength was graded using the standard 0–5 Medical Research Council (MRC) scale [30].
- TUG. The TUG assesses functional mobility, balance (both static and dynamic), and fall risk [31]. Patients were instructed to stand from a seated position in a standard armchair, walk 3 m at a comfortable pace, turn around, return to the chair, and sit down. Time to completion was recorded in seconds. A cutoff of >13.5 s has been associated with increased fall risk in older adults [32].
- 5×STS. This test measures lower limb muscle strength, power, and functional capacity [33]. Patients were asked to stand up and sit down from a standard chair five times as quickly as possible without using their arms. The total time to complete five repetitions was recorded and compared to age- and sex-specific normative values [34].
- 6MWT. The 6MWT measures functional exercise capacity and endurance [37]. Patients walked at their fastest comfortable pace along a flat, marked 30 m corridor for 6 min, with standardized encouragement provided at 1 min intervals. The total distance covered (in meters) was recorded. Baseline 6MWD was calculated as a percentage of predicted distance using validated reference equations accounting for age, sex, height, and weight [38].
2.3. Subjective Assessment Tools
- Self-Reported Health Status. Patients rated their overall perceived health status on a visual analog scale ranging from 0 (worst imaginable health) to 100 (best imaginable health).
- Visual Analog Scale (VAS) for Fatigue. Fatigue was assessed using a 0–10 VAS, with 0 representing no perceived exertion and 10 representing maximal exertion or exhaustion.
2.4. Data Collection and Management
2.5. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Functional Assessment Outcomes

| Measure | CAR-T Group (n = 5) | ASCT Group (n = 7) | p-Value |
|---|---|---|---|
| 6-MWD (meters) | |||
| Admission, median (range) | 287 (46–395) | 325 (192–480) | 0.53 |
| Discharge, median (range) | 355 (176–416) | 120 (0–449) | 0.10 |
| Change, median (range) | +79 (−40 to +148) | −84 (−415 to −31) | 0.005 |
| Within-group p-value | 0.19 | 0.016 | |
| BBS (0–56) | |||
| Admission, median (range) | 54 (44–54) | 55 (50–56) | 0.40 |
| Discharge, median (range) | 52 (46–54) | 49 (37–56) | 0.09 |
| Change, median (range) | 0 (−1 to +2) | −1 (−18 to 0) | 0.04 |
| Within-group p-value | 0.79 | 0.06 | |
| TUG (seconds) | |||
| Admission, median (range) | 8.7 (6.8–12.5) | 10 (7.8–12.5) | 0.45 |
| Discharge, median (range) | 9 (7.3–11.7) | 12.5 (6.6–18.3) | 0.08 |
| Change, median (range) | −0.4 (−1.3 to +1) | +1.5 (−1.4 to +7.5) | 0.03 |
| Within-group p-value | 0.69 | 0.09 | |
| 5×STS (seconds) | |||
| Admission, median (range) | 12.5 (7.1–17.9) | 15 (13.8–24.4) | 0.3 |
| Discharge, median (range) | 11.7 (9–12.1) | 15 (10.7–34.2) | 0.12 |
| Change, median (range) | −1 (−7 to +2.9) | 0 (−3.1 to +9.8) | 0.11 |
| Within-group p-value | 0.25 | 0.88 | |
3.3. Subjective Assessments
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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| Characteristic | CAR-T Group (n = 5) | ASCT Group (n = 7) |
|---|---|---|
| Age, years | ||
| Median (range) | 58 (48–64) | 53 (42–64) |
| Sex, n (%) | ||
| Male | 2 (40%) | 3 (60%) |
| Female | 3 (60%) | 4 (40%) |
| ECOG, n (%) | ||
| 0–1 | 4 | 7 |
| >2 | 1 | 0 |
| Body Mass Index, kg/m2 | ||
| Median (range) | 26.98 (19.98–30.96) | 28.39 (19.3–40.27) |
| Length of Stay, days | ||
| Median (range) | 26.8 (24–41) | 23.6 (19–31) |
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Feri, F.; Hutsava, Y.; Monico, R.; Morena, F.; Perriello, V.M. Physical Recovery After CAR-T Cell Therapy vs. Autologous Stem Cell Transplantation Assessed Through Quantitative Rehabilitation Measures. Biomedicines 2026, 14, 1912. https://doi.org/10.3390/biomedicines14091912
Feri F, Hutsava Y, Monico R, Morena F, Perriello VM. Physical Recovery After CAR-T Cell Therapy vs. Autologous Stem Cell Transplantation Assessed Through Quantitative Rehabilitation Measures. Biomedicines. 2026; 14(9):1912. https://doi.org/10.3390/biomedicines14091912
Chicago/Turabian StyleFeri, Flavio, Yuliya Hutsava, Rita Monico, Francesco Morena, and Vincenzo Maria Perriello. 2026. "Physical Recovery After CAR-T Cell Therapy vs. Autologous Stem Cell Transplantation Assessed Through Quantitative Rehabilitation Measures" Biomedicines 14, no. 9: 1912. https://doi.org/10.3390/biomedicines14091912
APA StyleFeri, F., Hutsava, Y., Monico, R., Morena, F., & Perriello, V. M. (2026). Physical Recovery After CAR-T Cell Therapy vs. Autologous Stem Cell Transplantation Assessed Through Quantitative Rehabilitation Measures. Biomedicines, 14(9), 1912. https://doi.org/10.3390/biomedicines14091912

