<qa>  What is the primary outcome measure?MethodsDesign: This will be a randomized crossover pilot clinical trial with participant study duration of 28 days. The crossover nature allows each patient to serve as hisher own control. Details of the study design are provided in the text. Briefly, patients presenting at Mayo Clinic Scottsdales Ambulatory Infusion Center AIC will be randomized to one of two arms: 1 receive an RBC transfusion as scheduled transfuse, or 2 abstain from the scheduled transfusion no-transfuse. After an appropriate washout period, patients will cross from the transfuse arm to the no-transfuse arm or vice-versa. Activity levels will be recorded continuously throughout the study with no need for intervention by the patient. In addition to device data, survey data will be collected via a weekly telephone interview. The primary outcome measures will include both technical performance metrics such as daily energy expenditure as well as practical performance metrics such as changes in step count. A variety of secondary outcome measures include daily sedentary time and PROMIS Global 10 scores. 