Integrative exercise and nutrition strategies in leukemia survivorship: implications for cognitive function and quality of life

Leukemia survivorship presents ongoing clinical and functional challenges, including persistent fatigue, metabolic disturbances, and reduced quality of life. Integrative, non-pharmacologic strategies that combine exercise and targeted nutrition may help address these late effects. This narrative review synthesizes current evidence on the physiological, molecular, and clinical impact of exercise training and nutritional interventions among leukemia survivors. Exercise programs, ranging from aerobic and resistance training to high-intensity interval and mobile health-based formats, consistently improve cardiorespiratory fitness, muscular strength, and fatigue outcomes, while modulating inflammatory cytokines such as interleukin-6 and tumor necrosis factor-α. Nutritional components including polyphenol-rich functional foods, omega-3 fatty acids, and microbiota-supportive diets contribute anti-inflammatory and antioxidant effects that may complement exercise in restoring immune and metabolic balance. Together, these approaches form a promising foundation for personalized supportive care in leukemia survivorship. Yet, most studies remain limited by small sample sizes, heterogeneous protocols, and short follow-ups. Future research should prioritize larger, leukemia-specific clinical trials integrating exercise and nutrition components, with standardized outcome measures to enable evidence-based recommendations for survivorship care.