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CLINICAL TRIAL article

Front. Oncol.
Sec. Hematologic Malignancies
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1472551
This article is part of the Research Topic Toward the Future Management of Patients with Chronic Lymphocytic Leukemia View all 4 articles

A sixteen-week progressive exercise training intervention in treatment-naïve chronic lymphocytic leukaemia: a randomised-controlled pilot study

Provisionally accepted
Frankie F. Brown Frankie F. Brown 1,2*Rebecca Oliver Rebecca Oliver 1,3Rachel Eddy Rachel Eddy 1Adam J. Causer Adam J. Causer 1Annabelle Emery Annabelle Emery 1Harrison D. Collier-Bain Harrison D. Collier-Bain 1David Dutton David Dutton 4Josephine Crowe Josephine Crowe 3Daniel Augustine Daniel Augustine 5John Graby John Graby 5Daniel Rees Daniel Rees 1Daniela Rothschild Rodriguez Daniela Rothschild Rodriguez 6Oliver J. Peacock Oliver J. Peacock 1Sally Moore Sally Moore 3James Murray James Murray 3James E. Turner James E. Turner 1,7John P. Campbell John P. Campbell 1,8*
  • 1 University of Bath, Bath, United Kingdom
  • 2 School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom
  • 3 Department for Haematology, Royal United Hospital Bath NHS Trust, Bath, Surrey, United Kingdom
  • 4 Great Western Hospitals NHS Foundation Trust, Swindon, United Kingdom
  • 5 Department for Cardiology, Royal United Hospital Bath NHS Trust, Bath, Somerset, United Kingdom
  • 6 School of Biological Sciences, University of Southampton, United Kingdom., Southampton, United Kingdom
  • 7 School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom., Birmingham, United Kingdom
  • 8 School of Medical and Health Sciences, Edith Cowan University, Cowan, Western Australia, Australia

The final, formatted version of the article will be published soon.

    Background: Chronic lymphocytic leukaemia (CLL) typically presents with asymptomatic, early-stage disease that is monitored until disease progression ("treatment-naïve" CLL). The objective of this pilot study was to assess the feasibility and preliminary safety of an exercise program in treatment-naïve CLL. We also sought to preliminarily assess the impact of the exercise program on disease activity, as it has been proposed that exercise training may reduce disease outgrowth in treatment-naïve CLL.Methods: Forty treatment-naïve CLL patients were recruited into this randomised-controlled pilot study, and after screening, n=28 were randomised into a 16-week, home-based, partially supervised, personalised, progressive exercise intervention (n=14: mean ± SD: age=62 ± 12 years) or 16-weeks of usual care, control group (n=14: mean ± SD: age=61 ± 10 years). The primary outcome measures were safety (number and severity of adverse events) and feasibility (uptake, retention, and adherence to the trial). Disease activity (CD5+/CD19+ CLL cells clonally restricted to kappa or lambda) and other immune cell phenotypes, with a principal focus on T cells, were measured by flow cytometry. Other secondary outcomes included: DEXA derived body composition, cardiorespiratory and functional fitness, resting cardiovascular measures.Results: Trial uptake was 40%, the overall retention rate was 86%, with 79% of the exercise group and 93% of the control group completing the trial. Adherence to the exercise intervention was 92±8%. One serious adverse event was reported unrelated to the trial, and one adverse event related to the trial was reported. The exercise intervention elicited a 2% increase in DEXA-derived lean mass in the exercise group compared to a 0.4% decrease in the control group (p=0.01). No between group differences were observed over time for whole-body mass, BMI, bone mineral density, body fat, blood pressure resting heart rate, or measures of cardiorespiratory or functional fitness (all p>0.05). No between group differences were observed over time for clonal CLL cells, CD4+ or CD8+ T cell subsets (all p>0.05). The exercise training program used in this study was feasible in people with treatment-naïve CLL who passed pre-trial screening, and we preliminarily conclude the exercise training program was safe and also resulted in an increase in lean mass.

    Keywords: CLL (Chronic Lymphocytic Leukemia ), Exercise Intervention, T cells, LEAN MASS, CD49d expression, CD38

    Received: 29 Jul 2024; Accepted: 05 Nov 2024.

    Copyright: © 2024 Brown, Oliver, Eddy, Causer, Emery, Collier-Bain, Dutton, Crowe, Augustine, Graby, Rees, Rothschild Rodriguez, Peacock, Moore, Murray, Turner and Campbell. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Frankie F. Brown, University of Bath, Bath, United Kingdom
    John P. Campbell, University of Bath, Bath, United Kingdom

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