A pilot study of an exercise intervention for AML patients undergoing induction chemotherapy.

Abstract

e19555 Background: Induction chemotherapy (IC) to treat acute myeloid leukaemia (AML) requires 4-5 weeks of hospitalization, leading to deconditioning, declines in quality of life (QOL) and significant fatigue. Four exercise studies have demonstrated improved fitness, strength, QOL, and fatigue in AML patients undergoing IC, but were limited by small sample sizes, recruitment of mostly younger adults and lack of safety data. Objectives: 1) To determine recruitment, retention and participation of AML patients in an exercise intervention during hospitalization for IC; 2) to provide efficacy estimates on physical fitness and QOL outcomes; 3) to examine safety of the exercise program. Methods: Patients presenting with newly diagnosed or relapsed AML scheduled to undergo IC at Princess Margaret Hospital were recruited. Subjects were approached 4-5 days per week to perform 30 minutes of individualized, supervised aerobic and resistance exercises. QOL was measured with the EORTC QLQ-C30 and fatigue with the FACT-F subscale. Fitness measures included VO2max, grip and leg strength, and 6-minute walk test. Outcomes were assessed at baseline and post-induction with descriptive statistics and paired t-tests. Results: Over 6 months, 35 of 47 eligible subjects were enrolled (mean age 56.4 y, SD 12.9). Recruitment was high (74%), retention was excellent (1 drop-out), adherence was very good (80%) and the intervention was safe (1 possible grade II toxicity in 600+ patient-days of follow-up). Preliminary efficacy estimates suggest benefits in QOL and physical fitness outcomes (Table). Conclusions: Exercise is a safe, promising intervention for improving fitness and QOL in AML patients undergoing curative treatment. Next steps are to conduct a randomized phase II trial and to examine impact of exercise on treatment tolerability. Changes in mean (SD) fitness and QOL measures between baseline and 1 month (n=35). Time point Fitness measures Baseline 1 mo P value 6-min walk test (ft) 962.5 (286) 1175.6 (365) 0.012 VO2 max (METS) 6.9 (1.8) 7.2 (1.7) 0.48 Timed 10 chair stands (s) 33.0 (26.0) 27.9 (11.5) 0.46 Grip strength (kg) 23.9 (11.0) 19.9 (11.4) 0.008 Quality of life Global QOL 45.3 (26.7) 49.0 (21.6) 0.31 FACT-F 31.5 (13.1) 32.5 (11.9) 0.35