Hollenbach Lina, Rogahn Julia, le Coutre Philipp, Schulze Susann, Muegge Lars-Olof, Geissler Jan, Gruen Julia, Junghanss Christian, Felser Sabine
Department of Internal Medicine, Clinic III - Hematology, Oncology and Palliative Care, Rostock University Medical Center, Rostock, Germany.
Department of Hematology, Oncology, and Cancer Immunology, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Front Oncol. 2024 Feb 21;14:1345050. doi: 10.3389/fonc.2024.1345050. eCollection 2024.
Tyrosine kinase inhibitors (TKIs) have significantly lowered mortality of chronic myeloid leukemia (CML) patients adjusting life expectancy to that of the standard population. However, CML and its treatment with TKIs causes a high disease burden. Physical exercise (PE) could be a non-pharmacological approach to reducing these and improving quality of life.
The aim of this study was to determine the individual disease burden as well as PE preferences of CML patients and to deduce thereof specific PE recommendations.
This multicenter survey was conducted in cooperation with the LeukaNET/Leukemia-patient network including CML patients aged ≥18 years (German Registry of Clinical Trials, DRKS00023698). The severity of selected symptoms was assessed using the adapted Myeloproliferative Neoplasms Symptom Assessment Form: 0 (absent), 1-30 (mild), 31-70 (moderate), or 71-100 (severe). Information about patients' PE needs and preferences depending on their motivation was recorded.
A total of 212 questionnaires were analyzed (52% female, median age 54 years). The prevalence of moderate-to-severe symptoms was 49% for fatigue, 40% for musculoskeletal pain, and 37% for concentration problems. Other commonly reported symptoms included skin reactions (42%) and weight gain (24%). The proportion of overweight/obese patients was 52%. Half of all respondents requested more information regarding PE. Patients with CML preferred individual training (82%), located outdoors (71%), at home (47%), or in an indoor swimming pool (31%). Regarding the training frequency, sports-inactive patients preferred a frequency of 1-2 training sessions per week, whereas sports-active patients preferred 3-4 sessions per week (p <0.001). Sports-inactive patients preferred a training time of 15-45 minutes, while sports-active patients preferred 30-60 minutes (p = 0.002). Subsequently, PE recommendations were developed for patients with CML. Combined resistance and endurance training (moderate intensity twice per week for 30 minutes) was recommended for beginners. Obese patients should prioritize joint-relieving sports. To reduce the risk of skin reactions, direct sunlight and possibly water sports should be avoided, and UV protection should be used.
Counseling and motivation of CML patients to be physically active should be part of the standard of care as well as support for implementation.
酪氨酸激酶抑制剂（TKIs）显著降低了慢性粒细胞白血病（CML）患者的死亡率，使预期寿命接近正常人群。然而，CML及其TKIs治疗带来了较高的疾病负担。体育锻炼（PE）可能是一种减轻这些负担并改善生活质量的非药物方法。
本研究旨在确定CML患者的个体疾病负担以及体育锻炼偏好，并据此得出具体的体育锻炼建议。
这项多中心调查是与白血病网络/白血病患者网络合作开展的，纳入了年龄≥18岁的CML患者（德国临床试验注册中心，DRKS00023698）。使用改编后的骨髓增殖性肿瘤症状评估表评估选定症状的严重程度：0（无）、1 - 30（轻度）、31 - 70（中度）或71 - 100（重度）。记录了患者根据其动机的体育锻炼需求和偏好信息。
共分析了212份问卷（52%为女性，中位年龄54岁）。疲劳的中重度症状患病率为49%，肌肉骨骼疼痛为40%，注意力不集中问题为37%。其他常见症状包括皮肤反应（42%）和体重增加（24%）。超重/肥胖患者的比例为52%。一半的受访者要求提供更多关于体育锻炼的信息。CML患者更喜欢个性化训练（82%），训练地点为户外（71%）、家中（47%）或室内游泳池（31%）。关于训练频率，不运动的患者更喜欢每周1 - 2次训练，而经常运动的患者更喜欢每周3 - 4次训练（p <0.001）。不运动的患者更喜欢15 - 45分钟的训练时间，而经常运动的患者更喜欢30 - 60分钟（p = 0.002）。随后，为CML患者制定了体育锻炼建议。建议初学者进行抗阻和耐力训练相结合（中等强度，每周两次各30分钟）。肥胖患者应优先选择减轻关节负担的运动。为降低皮肤反应风险，应避免阳光直射以及可能的水上运动，并使用紫外线防护措施。
对CML患者进行体育锻炼方面的咨询和激励应成为护理标准的一部分以及实施方面的支持。
