Tailoring a physical activity intervention to older adults receiving intensive chemotherapy for acute myeloid leukemia (AML): One size does not fit all

Abstract

Older adults are at risk for functional decline during acute myeloid leukemia (AML) therapy [ [1] Klepin H.D. Tooze J.A. Pardee T.S. et al. Effect of intensive chemotherapy on physical, cognitive, and emotional health of older adults with acute myeloid leukemia. J Am Geriatr Soc. 2016; 64: 1988-1995 Crossref PubMed Scopus (55) Google Scholar ]. While some survivors demonstrate resilience [ [2] Mohamedali H. Breunis H. Timilshina N. et al. Older age is associated with similar quality of life and physical function compared to younger age during intensive chemotherapy for acute myeloid leukemia. Leuk Res. 2012; 36: 1241-1248 Crossref PubMed Scopus (38) Google Scholar , [3] Timilshina N. Breunis H. Tomlinson G.A. et al. Long-term recovery of quality of life and physical function over three years in adult survivors of acute myeloid leukemia after intensive chemotherapy. Leukemia. 2019; 33: 15-25 Crossref Scopus (13) Google Scholar ], short-term declines in physical function can be dramatic during an induction hospitalization [ [1] Klepin H.D. Tooze J.A. Pardee T.S. et al. Effect of intensive chemotherapy on physical, cognitive, and emotional health of older adults with acute myeloid leukemia. J Am Geriatr Soc. 2016; 64: 1988-1995 Crossref PubMed Scopus (55) Google Scholar ]. Physical performance (measured by the Short Physical Performance Battery [SPPB]) is predictive of survival at the time of diagnosis [ [4] Klepin H.D. Geiger A.M. Tooze J.A. et al. Geriatric assessment predicts survival for older adults receiving induction chemotherapy for acute myelogenous leukemia. Blood. 2013; 121: 4287-4294 Crossref PubMed Scopus (254) Google Scholar ], declines during induction therapy [ [1] Klepin H.D. Tooze J.A. Pardee T.S. et al. Effect of intensive chemotherapy on physical, cognitive, and emotional health of older adults with acute myeloid leukemia. J Am Geriatr Soc. 2016; 64: 1988-1995 Crossref PubMed Scopus (55) Google Scholar ], and is associated with shorter survival when measured at the time of remission [ [5] Saad M. Loh K.P. Tooze J.A. et al. Geriatric assessment and survival among older adults receiving post-remission therapy for acute myeloid leukemia. Blood. 2020; 136: 2715-2719 Crossref PubMed Google Scholar ]. Interventions designed to maintain physical performance may enhance the quality of survivorship, eligibility for subsequent therapies, and could potentially improve survival [ 6 Alibhai S.M. Durbano S. Breunis H. et al. A phase II exercise randomized controlled trial for patients with acute myeloid leukemia undergoing induction chemotherapy. Leuk Res. 2015; (S0145-2126(15)30365-9) Crossref Scopus (39) Google Scholar , 7 Alibhai S.M. O’Neill S. Fisher-Schlombs K. et al. A pilot phase II RCT of a home-based exercise intervention for survivors of AML. Support Care Cancer. 2014; 22: 881-889 Crossref PubMed Scopus (33) Google Scholar , 8 Klepin H.D. Danhauer S.C. Tooze J.A. et al. Exercise for older adult inpatients with acute myelogenous leukemia: a pilot study. J Geriatr Oncol. 2011; 2: 11-17 Abstract Full Text Full Text PDF PubMed Scopus (50) Google Scholar , 9 Thomas R. Kenfield S.A. Yanagisawa Y. et al. Why exercise has a crucial role in cancer prevention, risk reduction and improved outcomes. Br Med Bull. 2021; 139: 100-119 Crossref Scopus (3) Google Scholar , 10 Ezzatvar Y. Ramírez-Vélez R. Sáez de Asteasu M.L. et al. Physical function and all-cause mortality in older adults diagnosed with cancer: a systematic review and meta-analysis. J Gerontol A Biol Sci Med Sci. 2021; 76: 1447-1453 Crossref Scopus (13) Google Scholar ].