Huesmann Johanna, Letsch Anne, Fransecky Lars, Spory Lea-Josephine, Das Gupta Dennis, Baldus Claudia D, Schmidt Thorsten
Department of Inner Medicine II (Hematology/Oncology) and University Cancer Center, Schleswig-Holstein (UCCSH), University Medical Center Schleswig-Holstein (UKSH), Kiel, Germany.
Support Care Cancer. 2025 Jan 14;33(2):94. doi: 10.1007/s00520-025-09148-8.
Prior research indicates that engaging in physical activity during chemotherapy can positively influence both physical and psychological parameters in individuals with hematological neoplasms. However, the most effective type, level, intensity, and frequency of exercise remains unclear.
We enrolled 53 patients to a clinical trial assessing a partly supervised hybrid training program including both strength and endurance components, commencing at onset of induction therapy (T0) for hematological malignancies, including AML (n = 29), ALL (n = 5), and NHL (n = 19). Endpoints to evaluate efficacy included muscle strength in kg, cardiovascular fitness in steps, balance in scores, quality of life (QoL), and fatigue. Data were compared at three time points: the beginning of treatment (T0), during consolidation (T1), and 12 ± 2 weeks later (T2).
Average adherence to protocol specified activities was 63.2% (± 40.0% s.d.) for participants without a stem cell transplant (No-SCT) and 51.5% (± 29.3% s.d.) for participants with AML between T0 and T2. No serious adverse reactions related to the exercise program were reported. Positive correlations were found between adherence and hand strength (T0-T1: left: r = 0.48, p < 0.05; right: r = 0.56, p < 0.05) for patients without stem cell transplant as therapy, as well as a strong association between higher adherence and lower appetite loss between T1 and T2 (No-SCT: r = -0.67, p = 0.001; AML: r = -0,49, p = 0,03). In participants with AML, it was also shown that higher adherence at T2 was associated with reduced symptom burden due to financial problems (r = -0,65, p = 0,004). However, other aspects of quality of life and fatigue showed only weak to moderate correlations with adherence.
This partly supervised hybrid exercise program during inpatient and outpatient care of patients with hematological cancer was safe and feasible. While useful in maintaining hand strength and reducing appetite loss in some patients, as well as reducing symptom burden due to financial problems in other patients, ambiguity was likely due to confounding factors, such as underlying disease biology and response to treatment. Corresponding author: Johanna Huesmann (johuesmann@gmx.de) (TRN: DRKS00034396, Date of registration: 07.06.2024; retrospectively registered).
先前的研究表明，化疗期间进行体育活动可对血液系统肿瘤患者的身体和心理参数产生积极影响。然而，最有效的运动类型、水平、强度和频率仍不明确。
我们招募了53名患者参加一项临床试验，评估一个部分监督的混合训练计划，该计划包括力量和耐力训练，从血液系统恶性肿瘤诱导治疗开始时（T0）开始，包括急性髓系白血病（AML，n = 29）、急性淋巴细胞白血病（ALL，n = 5）和非霍奇金淋巴瘤（NHL，n = 19）。评估疗效的终点指标包括以千克为单位的肌肉力量、以步数为单位的心血管健康状况、以分数为单位的平衡能力、生活质量（QoL）和疲劳程度。在三个时间点比较数据：治疗开始时（T0）、巩固治疗期间（T1）以及12±2周后（T2）。
未进行干细胞移植（No - SCT）的参与者对方案规定活动的平均依从率为63.2%（标准差±40.0%），AML患者在T0至T2期间的依从率为51.5%（标准差±29.3%）。未报告与运动计划相关的严重不良反应。未进行干细胞移植治疗的患者中，发现依从性与握力之间存在正相关（T0 - T1：左手：r = 0.48，p < 0.05；右手：r = 0.56，p < 0.05），并且在T1和T2之间，较高的依从性与较低的食欲减退之间存在强关联（No - SCT：r = -0.67，p = 0.001；AML：r = -0.49，p = 0.03）。在AML患者中，还表明T2时较高的依从性与因经济问题导致的症状负担减轻相关（r = -0.65，p = 0.004）。然而，生活质量和疲劳的其他方面与依从性仅显示出弱至中度的相关性。
在血液系统癌症患者的住院和门诊护理期间，这个部分监督的混合运动计划是安全可行的。虽然该计划有助于一些患者维持握力和减少食欲减退，以及减轻其他患者因经济问题导致的症状负担，但由于潜在疾病生物学和对治疗的反应等混杂因素，结果存在不确定性。通讯作者：约翰娜·胡斯曼（johuesmann@gmx.de）（试验注册号：DRKS00034396，注册日期：2024年6月7日；回顾性注册）
