A 16-week progressive exercise training intervention in treatment-naïve chronic lymphocytic leukaemia: a randomised-controlled pilot study
BackgroundChronic 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-naïv...
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Frontiers Media S.A.
2024-12-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1472551/full |
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| author | Frankie F. Brown Frankie F. Brown Rebecca Oliver Rebecca Oliver Rachel Eddy Adam J. Causer Annabelle Emery Harrison D. Collier-Bain David Dutton Josephine Crowe Daniel Augustine Daniel Augustine John Graby John Graby Daniel Rees Daniela Rothschild-Rodriguez Oliver J. Peacock Sally Moore James Murray James E. Turner James E. Turner John P. Campbell John P. Campbell |
| author_facet | Frankie F. Brown Frankie F. Brown Rebecca Oliver Rebecca Oliver Rachel Eddy Adam J. Causer Annabelle Emery Harrison D. Collier-Bain David Dutton Josephine Crowe Daniel Augustine Daniel Augustine John Graby John Graby Daniel Rees Daniela Rothschild-Rodriguez Oliver J. Peacock Sally Moore James Murray James E. Turner James E. Turner John P. Campbell John P. Campbell |
| author_sort | Frankie F. Brown |
| collection | DOAJ |
| description | BackgroundChronic 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.MethodsA total of 40 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.ResultsTrial uptake was 40%, and 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 with 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 and CD4+ or CD8+ T-cell subsets (all p > 0.05).ConclusionThe exercise training program used in this study was feasible in people with treatment-naïve CLL who passed pre-trial screening, and we preliminarily conclude that the exercise training program was safe and also resulted in an increase in lean mass.Clinical trial registrationhttps://doi.org/10.1186/ISRCTN55166064, identifier ISRCTN 55166064. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2024-12-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj-art-e892bff8d2cc40b49f4de1aa186bfd092024-12-05T06:28:41ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-12-011410.3389/fonc.2024.14725511472551A 16-week progressive exercise training intervention in treatment-naïve chronic lymphocytic leukaemia: a randomised-controlled pilot studyFrankie F. Brown0Frankie F. Brown1Rebecca Oliver2Rebecca Oliver3Rachel Eddy4Adam J. Causer5Annabelle Emery6Harrison D. Collier-Bain7David Dutton8Josephine Crowe9Daniel Augustine10Daniel Augustine11John Graby12John Graby13Daniel Rees14Daniela Rothschild-Rodriguez15Oliver J. Peacock16Sally Moore17James Murray18James E. Turner19James E. Turner20John P. Campbell21John P. Campbell22Department for Health, University of Bath, Bath, United KingdomSchool of Applied Sciences, Edinburgh Napier University, Edinburgh, United KingdomDepartment for Health, University of Bath, Bath, United KingdomDepartment for Haematology, Royal United Hospitals Bath NHS Foundation Trust, Bath, United KingdomDepartment for Health, University of Bath, Bath, United KingdomDepartment for Health, University of Bath, Bath, United KingdomDepartment for Health, University of Bath, Bath, United KingdomDepartment for Health, University of Bath, Bath, United KingdomDepartment for Haematology, Great Western Hospitals NHS Foundation Trust, Swindon, United KingdomDepartment for Haematology, Royal United Hospitals Bath NHS Foundation Trust, Bath, United KingdomDepartment for Health, University of Bath, Bath, United KingdomDepartment for Cardiology, Royal United Hospitals Bath NHS Foundation Trust, Bath, United KingdomDepartment for Health, University of Bath, Bath, United KingdomDepartment for Cardiology, Royal United Hospitals Bath NHS Foundation Trust, Bath, United KingdomDepartment for Health, University of Bath, Bath, United KingdomSchool of Biological Sciences, University of Southampton, Southampton, United KingdomDepartment for Health, University of Bath, Bath, United KingdomDepartment for Haematology, Royal United Hospitals Bath NHS Foundation Trust, Bath, United KingdomDepartment for Haematology, Royal United Hospitals Bath NHS Foundation Trust, Bath, United KingdomDepartment for Health, University of Bath, Bath, United KingdomSchool of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United KingdomDepartment for Health, University of Bath, Bath, United KingdomSchool of Medical and Health Science, Edith Cowan University, Perth, WA, AustraliaBackgroundChronic 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.MethodsA total of 40 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.ResultsTrial uptake was 40%, and 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 with 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 and CD4+ or CD8+ T-cell subsets (all p > 0.05).ConclusionThe exercise training program used in this study was feasible in people with treatment-naïve CLL who passed pre-trial screening, and we preliminarily conclude that the exercise training program was safe and also resulted in an increase in lean mass.Clinical trial registrationhttps://doi.org/10.1186/ISRCTN55166064, identifier ISRCTN 55166064.https://www.frontiersin.org/articles/10.3389/fonc.2024.1472551/fullCLL (chronic lymphocytic leukaemia)exercise interventionT cellslean massCD49d expressionCD38 |
| spellingShingle | Frankie F. Brown Frankie F. Brown Rebecca Oliver Rebecca Oliver Rachel Eddy Adam J. Causer Annabelle Emery Harrison D. Collier-Bain David Dutton Josephine Crowe Daniel Augustine Daniel Augustine John Graby John Graby Daniel Rees Daniela Rothschild-Rodriguez Oliver J. Peacock Sally Moore James Murray James E. Turner James E. Turner John P. Campbell John P. Campbell A 16-week progressive exercise training intervention in treatment-naïve chronic lymphocytic leukaemia: a randomised-controlled pilot study Frontiers in Oncology CLL (chronic lymphocytic leukaemia) exercise intervention T cells lean mass CD49d expression CD38 |
| title | A 16-week progressive exercise training intervention in treatment-naïve chronic lymphocytic leukaemia: a randomised-controlled pilot study |
| title_full | A 16-week progressive exercise training intervention in treatment-naïve chronic lymphocytic leukaemia: a randomised-controlled pilot study |
| title_fullStr | A 16-week progressive exercise training intervention in treatment-naïve chronic lymphocytic leukaemia: a randomised-controlled pilot study |
| title_full_unstemmed | A 16-week progressive exercise training intervention in treatment-naïve chronic lymphocytic leukaemia: a randomised-controlled pilot study |
| title_short | A 16-week progressive exercise training intervention in treatment-naïve chronic lymphocytic leukaemia: a randomised-controlled pilot study |
| title_sort | 16 week progressive exercise training intervention in treatment naive chronic lymphocytic leukaemia a randomised controlled pilot study |
| topic | CLL (chronic lymphocytic leukaemia) exercise intervention T cells lean mass CD49d expression CD38 |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1472551/full |
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