title: Is physical exercise possible in patients with critical cytopenia undergoing intensive chemotherapy for acute leukaemia or aggressive lymphoma?
abstract: Patients undergoing intensive chemotherapy for acute leukaemia or aggressive lymphoma not only suffer from the direct side effects of chemotherapy such as infections due to long-lasting immuno-suppression and aplasia, but also from marked fatigue and the inability to do normal physical activity. Furthermore, especially in patients with severe thrombocytopenia, anaemia and leukopenia, doctors recommend abstaining from physical exercise due to the risk of potential bleeding and tissue damage. The normally recommended cutoff level to perform exercise is 50,000 platelets per microliter or haemoglobin of 8 g/dl. This leads to a vicious cycle of losing physical strength and muscle with subsequent development of treatment-related cachexia and an increased treatment mortality. As number of publications focus on the importance of physical exercise in patients with solid tumours, increasing evidence is found that suggests positive effects on major clinical endpoints such as rate of infection, quality of life and even relapse rate and overall survival. With this work, we intended to address whether intense supervised ergometer training is feasible in patients with severe pancytopenia and whether it has any effect on patients undergoing high-dose chemotherapy. Furthermore, this study was initiated as the groundwork for a large phase III randomised trial.
authors.affiliation: Department of Hematology and Oncology, University of Cologne, Cologne, Germany. thomas.elter@uk-koeln.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Elter
authors.affiliation: Institute for Rehabilitation and Sports for the Disabled, German Sport University Cologne, Cologne, Germany.
authors.forename: Martina
authors.initials: M
authors.lastname: Stipanov
authors.affiliation: Department of Hematology and Oncology, University of Cologne, Cologne, Germany.
authors.forename: Eva
authors.initials: E
authors.lastname: Heuser
authors.affiliation: Department of Hematology and Oncology, University of Cologne, Cologne, Germany.|Max-Eder Nachwuchsgruppe der Deutschen Krebshilfe, Cologne, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: von Bergwelt-Baildon
authors.affiliation: Institute for Rehabilitation and Sports for the Disabled, German Sport University Cologne, Cologne, Germany.
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Bloch
authors.affiliation: Department of Hematology and Oncology, University of Cologne, Cologne, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Hallek
authors.affiliation: Institute for Rehabilitation and Sports for the Disabled, German Sport University Cologne, Cologne, Germany.
authors.forename: Freerk
authors.initials: F
authors.lastname: Baumann
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000740:Anemia / Q000209:etiology / Q000503:physiopathology; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017326:Clinical Trials, Phase III as Topic; D003131:Combined Modality Therapy; D005081:Exercise Therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007938:Leukemia / Q000150:complications / Q000188:drug therapy*; D008223:Lymphoma / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D010865:Pilot Projects; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D013177:Sports; D013921:Thrombocytopenia / Q000209:etiology
chemical_list: D000970:Antineoplastic Agents