Acute Myeloid Leukemia Clinical Trial
Official title:
A Pilot Exercise RCT for Acute Myeloid Leukaemia (AML) Patients Undergoing Induction Chemotherapy: Pre-randomization Phase
Fatigue, reduced quality of life and declines in physical function are common in patients undergoing chemotherapy for acute myeloid leukaemia (AML). Studies in other cancer patients undergoing treatment have shown that exercise improves these symptoms, but there are limited studies in AML. This study of a hospital-based exercise program will help determine if exercise is both feasible and helpful in improving symptoms among for AML patients undergoing chemotherapy.
Background: Acute myeloid leukaemia (AML) is a life-threatening haematological malignancy.
Initial treatment with induction chemotherapy requires 4-5 weeks of hospitalization, with a
risk of physical deconditioning, declines in quality of life (QOL), and significant fatigue.
Four pilot exercise studies have demonstrated improved fitness, strength, QOL, and fatigue
in patients undergoing induction, but are limited by small sample sizes, recruitment of
mostly younger adults, inconsistent endpoints, and design issues. Prior to conducting a
large multi-centre randomized controlled trial (RCT), important pilot work first needs to be
done to demonstrate feasibility of a randomized trial of an exercise program in AML patients
undergoing induction chemotherapy; to ensure safety; and to provide effect estimates of the
intervention on fitness and QOL/fatigue endpoints.
Objectives: Primary objectives are: (1) to determine feasibility of recruitment and
retention of adult AML patients to a randomized trial of supervised exercise and ability of
patients to perform an exercise intervention in hospital; (2) to provide estimates of the
effect of exercise on fitness parameters. Secondary objectives are: (1) to determine effects
of exercise on QOL and fatigue; (2) to understand the impact of exercise on AML treatment
tolerability; (3) to examine safety of the exercise intervention. Methods: Thirty-five
patients age 18 or older with newly diagnosed or relapsed AML who are undergoing induction
chemotherapy will be recruited at Princess Margaret Hospital. Participants will perform
30-45 minutes of supervised aerobic and resistance exercises 4-5 days per week. Primary
outcomes are recruitment rate, exercise adherence rate, and impact on fitness measures (peak
aerobic capacity (VO2peak), grip strength, leg strength, 6-minute walk test). QOL will be
measured with the European Organization for the Research and Treatment of Cancer (EORTC)
core 30-item questionnaire (QLQ-C30). Fatigue will be measured using the Functional
Assessment of Cancer Therapy fatigue subscale (FACT-Fatigue). Treatment tolerability
outcomes include length of stay, intensive care unit admission, and the development of
sepsis. Outcomes over time will be assessed using mixed effects regression models.
Significance: Exercise is a promising intervention for improving fitness, QOL and treatment
tolerability in AML patients undergoing induction chemotherapy. This pilot RCT will
establish feasibility and safety, as well as provide efficacy estimates that will be vital
to the design and conduct of a definitive multi-centre RCT of exercise in this patient
population.
;
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Supportive Care
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