Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Effect of a Multi-Component Exercise Training and Sedentary Behaviour Intervention during Allogeneic Stem Cell Transplant on Body Composition (#522)

Hayley T Dillon 1 2 , Nicholas J Saner 2 3 , Tegan Ilsley 2 4 , David S Kliman 5 , David W Dunstan 1 2 , Robin M Daly 1 , Steve F Fraser 1 , Bronwyn A Kingwell 6 , Andre La Gerche 7 8 9 10 , Erin J Howden 2 11
  1. Institute for Physical Activity and Nutrition, Deakin University, Melbourne, VIC, AU
  2. Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
  3. Institute for health and sport, Victoria University, Melbourne, VIC, Australia
  4. Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, AU
  5. Department of Haematology, Royal North Shore Hospital, Sydney, NSW, Australia
  6. CSL, Melbourne, VIC, AU
  7. Heart, Exercise and Research Trials (HEART) Lab, St Vincent's Institute, Melbourne, VIC, Australia
  8. Department of Cardiovascular Science, KU Leuven, Leuven, Belgium
  9. Cardiology Department, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
  10. HEART Lab, Victor Chang Cardiovascular Research Institute, Darlinghurst, NSW, Australia
  11. Baker Department of Cardiometabolic Health, University of Melbourne, Parkville, VIC, Australia

Background/Aim. Significant weight loss and unfavourable body composition changes (i.e. muscle atrophy, central adiposity) are commonly observed during allogeneic stem cell transplantation (allo-SCT) and have been associated with worsened clinical outcomes. This RCT investigated the effect of a multi-component activity intervention during allo-SCT on body composition.

Methods. This is a secondary analysis of a 4-month, RCT in which 62 haematological cancer patients scheduled for allo-SCT were randomized to usual care (UC, n=32), or a multi-component activity intervention (Activity, n=30) combining thrice-weekly aerobic and resistance exercise training with sedentary time reduction (≥30-min.day-1). The Activity program was delivered throughout hospitalisation (~4-weeks) and for 12-weeks after discharge. Total body lean (LM) and fat mass (FM), and visceral adipose tissue (VAT) mass, were measured via dual-energy x-ray absorptiometry pre-admission, and 12-weeks following discharge (4-months).

Results. Median (IQR) Activity intervention adherence was 74% (41-96%). During hospitalisation, Activity attenuated the decline in total mass (-2.3kg vs -5.7kg; interaction, p<0.001). Similarly, Activity preserved LM during hospitalisation (-0.33kg [-1.47, 0.81], p=0.57), which declined with UC (LM: -2.0kg [-3.36, -0.64], p=0.02; interaction, p=0.40). However, there was no treatment effect on total mass and LM at 4-months (interactions, p=0.70 and p=0.90, respectively), consequent to declines with Activity during the outpatient phase (Total mass: -3.60kg [-6.19, -1.01]; LM: -1.67kg [-3.23, -0.12]), and no further decline in UC (Total mass: -1.6kg [-3.82, 0.56]; LM: 0.14kg [-1.15, 1.4]). FM declined comparably in Activity and UC at discharge (-5.5% vs -9.5%; p=0.11) and 4-months (10.8% vs -15.8%; p=0.20). There were no changes in VAT mass in either group.

Conclusion. Thrice-weekly exercise training and daily sedentary time reduction did not prevent weight loss and muscle atrophy in adults undergoing allo-SCT. These results highlight the importance of nutritional interventions (targeting energy/protein modulation) for facilitating exercise training adaptations and ameliorating body compositional alterations.