Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

A 12-week exercise program improves exercise capacity in acute leukemia patients post intensive chemotherapy (#84)

Lauren A Burnham 1 , Nicholas NS Saner 2 , Sarah SA Alexander 1 , Hayley HD Dillon 1 , Catherine CV Vassili 3 , Catriona CP Parker 4 , Shaun SF Fleming 3 , Andrew AW Wei 5 6 , Erin EH Howden 1
  1. Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
  2. Victoria University, Melbourne, Victoria, Australia
  3. The Alfred, Melbourne, VIC, Australia
  4. Transfusion Research Unit, Monash University, Melbourne, VIC, Australia
  5. Royal Melbourne Hospital, Melbourne, VIC, Australia
  6. Peter MacCallum Cancer Centre, Melbourne, VIC, Australia

Introduction – Survivors of acute lymphoblastic leukemia (ALL) and myeloid leukemia (AML) are treated with intensive chemotherapy, which can leave patients physically deconditioned. Exercise improves survivorship outcomes in other patient groups but has not been tested in early survivorship for ALL and AML patients. Accordingly, we sought to test the feasibility and efficacy of an exercise program in early survivorship.

Methods – Eighteen patients (52 ± 16y, 62% male) with AML or ALL were recruited within 3 months of completion of intensive and consolidation chemotherapy to participate in a 12-week exercise intervention. The intervention consisted of individualised aerobic training: two moderate intensity continuous (50-70% heart rate reserve (HRR); 20-30mins) and one high interval (>70%HRR; 4x2-4mins) sessions per week, and two resistance training sessions per week (6-10 upper and lower body exercises).  To evaluate efficacy, changes in peak oxygen uptake (VO2peak) and peak watts were assessed by cardiopulmonary exercise testing, functional capacity change in 6-minute walk distance (6MW), and body mass index (BMI). To assess the feasibility the %sessions completed are reported (100% of completed session =36).

Results – Three participants did not complete follow up CPET due to disease relapse. Eleven participants completed >75% of the prescribed exercise, and adherence ranged from 63-97%. Training increased both absolute and relative VO2peak 14.1% (1.95±0.42 to 2.23±0.48L.min-1, p<0.001) and 10.4% (23.1±5.2 to 25.5±5.2mL.kg-1.min-1, p<0.001) respectively; and peak watts by 16.5% (168±36 vs 195±43W, p<0.001). BMI increased by 2.8% (29.5±6.1 vs 30.3±6.5kg/m2, p=0.003). In a subset of patients who completed 6MW at follow-up (n=9) distance increased by 4.7% (559±39 vs 585±43metres, p = 0.02).

Conclusions – Exercise training that is individualised is feasible to complete during early AML and ALL survivorship and leads to improved cardiorespiratory fitness and functional capacity. Further research is required to determine the impact on long-term survivorship outcomes.