Quality of Life Changes Following High-intensity Interval Training in Older Adults with Chronic Lymphocytic Leukemia

Chronic lymphocytic leukemia (CLL) is the most common incurable leukemia in the United States. Individuals with CLL are at risk for disability, frailty, and cancer-specific complications, which negatively affect quality of life (QOL). Exercise has improved QOL in other cancer populations; however, limited studies have examined the impact of exercise on QOL in CLL. PURPOSE: The purpose of this study was to examine the effects of a 12-week high-intensity interval training and resistance training (HIIT+RT) intervention on QOL in adults with treatment naïve CLL. METHODS: In this quasi-experimental pilot study, we non-randomly assigned individuals with CLL (aged 63.9 ± 8.5 yrs) to 12 weeks of HIIT+RT or a control group. The HIIT+RT protocol consisted of 30 min of HIIT 3x/wk along with RT 2x/wk. The control group maintained usual activities. We assessed pre and post QOL using the Functional Assessment of Cancer Therapy-Lymphoma (FACT-Lym) questionnaire with subdomains of physical (PWB), social (SWB), emotional (EWB), functional (FWB), and general (FACT-G) well-being as well as a lymphoma-specific subscale (LymS). We used a two-way repeated-measures analysis of variance to assess changes in QOL. We accepted significance at p ≤ 0.05. RESULTS: Fifteen participants (HIIT+RT: n=9; Control: n=6) completed the study and questionnaire. We observed a main effect of time that indicated improved score for FACT-Lym (143.7 ± 10.9 to 150.9 ± 7.4), FWB (23.3 ± 3.5 to 24.6 ± 2.9), FACT-G (92.9 ± 7.5 to 96.3 ± 5.3), and LymS (50.9 ± 4.9 to 54.5 ± 4.2). In each case, only HIIT+RT improved FACT-Lym (138.6 ± 9.4 to 147.9 ± 6.7, p<0.001), FWB (21.7 ± 3.4 to 23.9 ± 3.2; p=0.001), FACT-G (89.2 ± 6.6 to 94.6 ± 5.5, p=0.002), and LymS (49.3 ± 3.9 to 53.3 ± 4.2, p=0.009). The control group had no significant changes in QOL scores. CONCLUSION: Given that adults with CLL experience reduced physical function and QOL, our findings are promising as HIIT+RT improved FACT-Lym scores and domains specific to function, general well-being, and lymphoma-related symptoms. Moreover, these changes represent clinically meaningful improvements. Funding: Duke Aging Center Postdoctoral Research Training Grant (NIA T32 AG000029), Duke Pepper Center Pilot Study Award (NIA P30-AG028716), ASH Scholar Award, NHLBI T32 Grant (T32HL007057), Durham VA Medical Center Research Service