A new randomised controlled trial out of the Baker Heart and Diabetes Institute has found that combining structured exercise training with reductions in sitting time protects against heart damage and declines in cardiovascular fitness in adults receiving stem cell transplantation for blood cancers.
The average blood cancer patient loses 15–24 per cent of their cardiovascular fitness during the allogeneic stem cell transplantation process and acute recovery phase (three-to-four months), the equivalent of around two decades of normal cardiovascular ageing, ALLO-Active trial lead researcher Hayley Dillon said.
Findings from the trial, published in Circulation, revealed that patients who participated in the four-month, multi-component activity program showed significantly better preservation of their cardiorespiratory fitness and cardiac function during and after the transplantation process, compared to those receiving standard care.
Associate Professor Erin Howden, senior researcher and Head of the Baker Institute's Cardiometabolic Health and Exercise Physiology research, said this is a significant step forward in improving long-term outcomes for allogeneic stem cell transplant patients.
"It might sound counter-intuitive to exercise while undergoing treatment for cancer, but we've found that intervening during and following hospitalisation for allogeneic stem cell transplantation with an activity program that combines structured exercise training and reductions in sedentary time, counteracts the declines in cardiorespiratory fitness and exercise cardiac function, as compared with standard-of-care-treatment," she said.
"The reason why attenuating that decline is so important is because we are seeing a growing number of cancer survivors with heart damage — a known complication of some cancer treatments. This treatment-impaired cardiac function and functional capacity are known contributors of premature cardiovascular disease (CVD) development and CVD-related deaths."
More than 600 Australians receive an allogeneic (stem cell donor) stem cell transplant each year.
"This study found exercise training to be a promising therapy for attenuating the cardiovascular toxicity associated with blood cancer treatments and represents a significant step forward in improving long-term outcomes for stem cell transplant patients," A/Prof Howden said. "It demonstrates that exercise can play a critical role in preserving heart health during and after treatment."
The study, part funded by a Wereld Kanker Onderzoek Fonds grant, as part of the World Cancer Research Fund International network, also showed that exercise-based measures of cardiac function may be a better means of detecting subclinical cardiotoxicity and determining cardiovascular risk in patients receiving an allogeneic stem cell transplant.
"This is a particularly exciting study as it is the first randomised controlled trial to target exercise and sedentary behaviour to lower cardiovascular risk in patients receiving allogeneic stem cell transplants," Dr Helen Croker, Assistant Director of Research and Policy at World Cancer Research Fund International, said.
"The positive results strengthen the scientific evidence for including exercise and reducing sedentary time as additional therapies in routine cancer care. These interventions could significantly benefit patients and enhance their future treatment and care".
