ORIGINAL ARTICLE Telephone-delivered nutrition and exercise counselling after auto-SCT: a pilot, randomised controlled trial Y-C Hung 1 , JD Bauer 1,2 , P Horsely 2 , J Coll 2 , J Bashford 3 and EA Isenring 1,4 Adverse changes in nutrition-related outcomes including quality of life (QoL) occur after PBSC transplantation. This randomised controlled trial aims to evaluate the impact of nutrition and exercise counselling provided at hospital discharge on nutritional status, body composition and QoL post transplantation. Usual care (UC) (n = 19) received no intervention after discharge; extended care (EC) (n = 18) received fortnightly telephone counselling from a dietitian and exercise physiologist up to 100 days post transplantation. Nutritional status (patient-generated subjective global assessment, and diet history), QoL (EORTC QLQ-C30 version 3) and body composition (air displacement plethysmography) were assessed at pre-admission, discharge and 100 days post transplantation. Intervention groups were compared using two-sample t-tests of changes in the outcomes; results were adjusted using analysis of covariance. EC exhibited clinically important but not statistically significant increases in protein intake (14.7 g; confidence interval (CI) 95% - 6.5, 35.9, P = 0.165), cognitive functioning (7.2; CI 95% - 7.9, 22.2, P = 0.337) and social functioning (16.5; CI 95% - 7.3, 40.3, P = 0.165) compared with UC. Relative to pre-admission, EC experienced less weight loss than UC (-3.3 kg; CI 95% - 6.7, 0.2, P = 0.062). Physical activity was not significantly different between the groups. Ongoing nutrition and exercise counselling may prevent further weight loss and improve dietary intake and certain QoL components in autologous PBSC transplantation patients following hospitalisation. Bone Marrow Transplantation (2014) 49, 786–792; doi:10.1038/bmt.2014.52; published online 7 April 2014 INTRODUCTION Approximately 10% of patients diagnosed with haematological malignancies in Australia are treated with high dose conditioning and PBSC transplantation. 1 The treatment is accompanied by complications and side effects that adversely affect nutritional status, 2,3 body composition, 3,4 quality of life (QoL) and functioning capacity (that is, work) 5 for prolonged periods of time. The role of nutrition intervention, 6,7 exercise intervention 8,9 or combined nutrition and exercise interventions 10,11 amongst cancer survivors have shown to reverse or improve treatment- related side effects. However, these results may not be applicable to haematological cancer patients treated with PBSC transplanta- tion as most studies were conducted on patients with solid tumours (that is, breast, prostate and colon). To date, several studies have examined the role of exercise across different phases of PBSC transplantation (that is, before, during and after hospital discharge), 12–16 but no study has examined the role of nutrition support delivered by a dietitian amongst PBSC transplantation patients after hospital discharge. We have previously demonstrated that the immediate impact of transplantation on nutritional status, body composition, QoL and physical activity level (PAL) amongst a group of autologous PBSC transplantation patients resolved gradually over the first 100 days post transplantation. However, the deficit of lean body mass (LBM) remained notable, and one in three patients continued to experience nutrition impact symptoms. 3 On the basis of our observational study, we were interested in whether the reversal of treatment-related adverse effects after hospital discharge would be improved if patients were provided with ongoing nutrition counselling with the addition of exercise counselling following hospital discharge. In research settings, exercise has shown to optimise body composition and improve QoL amongst haemato- logical cancer patients (with or without PBSC transplantation). 17 At present, exercise is not provided as a part of standard inpatient care for PBSC transplantation patients. As the clinic which participated in this study provided a service to the state of Queensland (1 727 000 km 2 ), a pilot study using telephone-delivered intervention was proposed to allow the inclusion of patients residing in rural or semi-rural areas where access to facilities providing nutrition or exercise counselling services may be limited. The aim of this pilot randomised controlled trial was to evaluate the feasibility (that is, safety and adherence) and the effectiveness of a home-based, telephone-delivered nutrition and exercise intervention on nutritional status, body composition, QoL and PAL amongst cancer patients treated with autologous PBSC transplan- tation up to 100 days post transplantation compared with those provided with usual care (UC). PATIENTS AND METHODS This study was conducted based on our earlier findings. 3 Eligible candidates were adult (⩾18 years old) haematological cancer patients scheduled for autologous PBSC transplantation from a single transplanta- tion centre, the Haematology and Oncology Clinics of Australia, The Wesley Hospital, Brisbane, Australia. Patients undergoing allogeneic transplant or 1 Centre for Dietetics Research, School of Human Movement Studies, The University of Queensland, Brisbane, Queensland, Australia; 2 The Wesley Research Institute, Brisbane, Queensland, Australia; 3 Haematology & Oncology Clinics of Australia, The Wesley Medical Centre, Brisbane, Queensland, Australia and 4 Department of Nutrition & Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia. Correspondence: Y-C Hung, Centre for Dietetics Research, School of Human Movement Studies, The University of Queensland, Building 26B, Brisbane, Queensland 4072, Australia. E-mail: yui.hung@uqconnect.edu.au Received 12 July 2013; revised 24 January 2014; accepted 29 January 2014; published online 7 April 2014 Bone Marrow Transplantation (2014) 49, 786 – 792 © 2014 Macmillan Publishers Limited All rights reserved 0268-3369/14 www.nature.com/bmt