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Is physical exercise possible in patients with critical cytopenia undergoing intensive chemotherapy for acute leukaemia or aggressive lymphoma?

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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 loosing physical strength and muscles 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.

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Authors and Affiliations

  1. Department of Hematology and Oncology, University of Cologne, Cologne, Germany

    Thomas Elter, Eva Heuser, Michael von Bergwelt-Baildon & Michael Hallek

  2. Institute for Rehabilitation and Sports for the Disabled, German Sport University Cologne, Cologne, Germany

    Martina Stipanov, Wilhelm Bloch & Freerk Baumann

  3. Max-Eder Nachwuchsgruppe der Deutschen Krebshilfe, Cologne, Germany

    Michael von Bergwelt-Baildon

Authors
  1. Thomas Elter
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  2. Martina Stipanov
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  3. Eva Heuser
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  4. Michael von Bergwelt-Baildon
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  5. Wilhelm Bloch
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  6. Michael Hallek
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  7. Freerk Baumann
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Correspondence to Thomas Elter.

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Elter, T., Stipanov, M., Heuser, E. et al. Is physical exercise possible in patients with critical cytopenia undergoing intensive chemotherapy for acute leukaemia or aggressive lymphoma?. Int J Hematol 90, 199–204 (2009). https://doi.org/10.1007/s12185-009-0376-4

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  • DOI: https://doi.org/10.1007/s12185-009-0376-4

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