The Physiological Impact Of A 12-Week Exercise Intervention On Chronic Lymphocytic Leukemia Frailty-Risk

PURPOSE: Adults with treatment naïve (TN) and treated (Td) chronic lymphocytic leukaemia (CLL) face an elevated risk of physical dysfunction and frailty. While targeted exercise programs in the general population can prevent frailty, it is unknown if exercise reduces frailty risk in CLL. We aimed to determine the role of exercise training on physiological frailty indicators between TN and Td CLL. METHODS: Fifteen adults [5F/10M: aged 66.4 years (range: 51-79 years)] with TN (N = 8) or Td (N = 7) CLL completed a randomised control trial of a 12-week aerobic and resistance training intervention (EXE) or no exercise (CON). Assessments included frailty measures and high-resolution physiological assessments of VO2peak, muscle quality, strength, and health. Participants completed a 30-minute aerobic session at the start and end of the intervention, assessing heart rate, muscle oxygenation and muscle fuel use. Data was analysed by repeated measures and univariate ANOVA. RESULTS: At baseline and after 12 weeks of exercise, Td and TN had similar frailty, physiological measures, and responses (p > 0.05). Compared to CON, EXE groups increased upper (17.5 ± 12.1%, p < 0.05) and lower body (21.3 ± 12.0%, p < 0.05) muscle strength. EXE groups' exhibited increased time to exhaustion (11.0 ± 5.2%, p = 0.05) and anaerobic threshold (19.5 ± 11.3%, p = 0.001), with trends for increased relative (7.3 ± 8.19%, p < 0.09) and absolute VO2peak (5.8 ± 6.6%, p < 0.09). Frailty measures, sit to stand (41.3 ± 37.3%, p < 0.05) and arm curl (24.5 ± 27.3%, p < 0.05), also increased in EXE groups. No differences were observed in muscle health (fuel or oxygenation) between EXE and CON or in response to exercise training. We found relationships between VO2peak changes and muscle health changes during acute exercise sessions. Changes in VO2peak were associated with increased muscle O2 resaturation rates (r = .894, p = 0.041), higher peak muscle O2 during recovery (r = 1.00, p < 0.001), and positively correlated with changes in average O2 extraction (r = .920, p = 0.027). CONCLUSIONS: A 12-week exercise intervention yields positive physiological and frailty-risk changes in CLL patients, regardless of treatment status. Our preliminary analysis suggests that exercise training may offset the risk of frailty in CLL. American Society of Hematology