A phase II exercise randomized controlled trial for patients with acute myeloid leukemia undergoing induction chemotherapy

S M H Alibhai; S Durbano; H Breunis; J M Brandwein; N Timilshina; G A Tomlinson; P I Oh; S N Culos-Reed

doi:10.1016/j.leukres.2015.08.012

A phase II exercise randomized controlled trial for patients with acute myeloid leukemia undergoing induction chemotherapy

Leuk Res. 2015 Aug 28:S0145-2126(15)30365-9. doi: 10.1016/j.leukres.2015.08.012. Online ahead of print.

Authors

S M H Alibhai¹, S Durbano², H Breunis², J M Brandwein³, N Timilshina², G A Tomlinson⁴, P I Oh⁵, S N Culos-Reed⁶

Affiliations

¹ Department of Medicine, University Health Network, Toronto, Canada; Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada. Electronic address: shabbir.alibhai@uhn.on.ca.
² Department of Medicine, University Health Network, Toronto, Canada.
³ Department of Medicine, University of Alberta, Edmonton, Canada.
⁴ Department of Medicine, University Health Network, Toronto, Canada; Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada; Department of Public Health Sciences, University of Toronto, Toronto, Canada.
⁵ The Cardiac Rehabilitation and Secondary Prevention Program, Toronto Rehabilitation Institute, Toronto, Canada.
⁶ Faculty of Kinesiology, University of Calgary, Calgary, Canada.

PMID: 26350143
DOI: 10.1016/j.leukres.2015.08.012

Abstract

Curative treatment for acute myeloid leukemia (AML) involves induction chemotherapy (IC) which is associated with bed rest and toxicities, leading to worsening quality of life (QOL), fatigue, and fitness. Exercise during IC may ameliorate declines but has not been rigorously tested. We examined the efficacy of supervised exercise during IC on QOL, fatigue, and fitness. Eighty-three inpatients age 18-80 scheduled to receive IC for newly diagnosed or relapsed AML were randomized 2:1 (exercise intervention:control group). Study measures were completed at baseline, post-IC, and following the first cycle of consolidation. The intervention consisted of a supervised mixed-modality, moderate-intensity exercise program (4-5 days per week, 30-60min per session) throughout admission. Recruitment was good (56%), retention excellent (96%), and adherence was 54%. Global QOL improved similarly in both groups from baseline to post-IC (between-group difference 3.0 points, p=0.62). Fatigue improved in the exercise group from baseline to post-IC (potentially clinically important between-group difference of 3.6 points, p=0.23). Aerobic fitness, lower body strength, and grip strength improved in the exercise group (between-group differences p=0.005, p<0.001, p=0.03, respectively). Supervised exercise for patients with AML undergoing IC is feasible, safe, and appears effective at improving fitness and possibly fatigue. A larger trial is warranted.

Keywords: Acute myeloid leukemia; Cancer-related fatigue; Chemotherapy; Exercise; Quality of life.