Xu Wenkui, Li Zhangjie, Wang Chunfeng, Chen Jingyi, Wu Yong, Hu Rong
The School of Nursing, Fujian Medical University, No. 1 Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, 350108, Fujian Province, China.
Department of Hematology, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, 350001, China.
Sci Rep. 2025 Feb 15;15(1):5632. doi: 10.1038/s41598-025-89703-9.
This study aimed to investigate the changes in physical fitness and patient-reported outcomes as well as the correlation between these two factors in adult patients with newly diagnosed acute leukemia during chemotherapy. This was a longitudinal observational study. Patients were recruited from a tertiary hospital in China with a follow-up period of less than 90 days. Physical fitness was assessed using body mass index (BMI), mean skinfold thickness, waist-to-hip ratio, spirometry, mean grip strength, and flexibility at T1 (before chemotherapy), T2 (7-14 days after initial chemotherapy), and T3 (completely relieved or after two chemotherapy courses). A repeated-measures analysis of variance was used to analyze the physical fitness changes during follow-up. Multiple linear regression was used to analyze the factors influencing patient-reported outcomes. The study analyzed 121 patients. Changes in physical fitness during chemotherapy, including BMI, mean skinfold thickness, lung capacity and flexibility were not all equal at all three time points (F = 38.477, P < 0.001; F = 44.506, P < 0.001; F = 70.948, P < 0.001; and F = 70.965, P < 0.001), and post-hoc tests showed that they all trended to be decreasing before they were elevated (T2 < T3 < T1). The waist-to-hip ratio decreased and then increased (F = 12.138, P < 0.001,T2 < T3 = T1) and the mean grip strength remained stable (F = 0.137, P = 0.718). The total patient-reported outcome scale score decreased and subsequently increased (F = 362.507, P < 0.001,T2 < T1 < T3). BMI, mean skinfold thickness, spirometry, and flexibility influenced the patient-reported outcomes (B = 1.427,P < 0.001; B=-15.340,P < 0.001; B = 0.002,P = 0.014; B = 0.249,P < 0.001). Physical fitness affects patient-reported outcomes in those with acute leukemia. During chemotherapy, especially myelosuppression, healthcare providers should monitor patients' physical fitness and implement positive patient-appropriate interventions, such as exercise interventions, to promote better outcomes.
本研究旨在调查新诊断的成年急性白血病患者在化疗期间的体能变化、患者报告的结局，以及这两个因素之间的相关性。这是一项纵向观察性研究。患者来自中国一家三级医院，随访期少于90天。在T1（化疗前）、T2（初始化疗后7 - 14天）和T3（完全缓解或两个化疗疗程后），使用体重指数（BMI）、平均皮褶厚度、腰臀比、肺活量测定、平均握力和柔韧性来评估体能。采用重复测量方差分析来分析随访期间的体能变化。使用多元线性回归分析影响患者报告结局的因素。该研究分析了121例患者。化疗期间的体能变化，包括BMI、平均皮褶厚度、肺容量和柔韧性在所有三个时间点并不完全相同（F = 38.477，P < 0.001；F = 44.506，P < 0.001；F = 70.948，P < 0.001；F = 70.965，P < 0.001），事后检验表明，它们在升高之前均呈下降趋势（T2 < T3 < T1）。腰臀比先下降后上升（F = 12.138，P < 0.001，T < T3 = T1），平均握力保持稳定（F = 0.137，P = 0.718）。患者报告结局量表的总分先下降后上升（F = 362.507，P < 0.001，T2 < T1 < T3）。BMI、平均皮褶厚度、肺活量测定和柔韧性影响患者报告的结局（B = 1.427，P < 0.001；B = -15.340，P < 0.001；B = 0.002，P = 0.014；B = 0.249，P < 0.001）。体能会影响急性白血病患者报告的结局。在化疗期间，尤其是骨髓抑制期间，医护人员应监测患者的体能，并实施积极的、适合患者的干预措施，如运动干预，以促进更好的结局。
