Physical activity and physical fitness in lymphoma patients before, during, and after chemotherapy: a prospective longitudinal study. Nele Vermaete, Pascal ...
Physical activity and physical fitness in lymphoma patients before, during, and after chemotherapy: a prospective longitudinal study Nele Vermaete, Pascal Wolter, Gregor Verhoef & Rik Gosselink
Annals of Hematology ISSN 0939-5555 Ann Hematol DOI 10.1007/s00277-013-1881-3
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Author's personal copy Ann Hematol DOI 10.1007/s00277-013-1881-3
ORIGINAL ARTICLE
Physical activity and physical fitness in lymphoma patients before, during, and after chemotherapy: a prospective longitudinal study Nele Vermaete & Pascal Wolter & Gregor Verhoef & Rik Gosselink Received: 29 May 2013 / Accepted: 6 August 2013 # Springer-Verlag Berlin Heidelberg 2013
Abstract Fatigue is a common and distressing symptom in cancer patients, especially in lymphoma patients. One hypothesized mechanism in the etiology of fatigue is a vicious circle between fatigue, physical inactivity, and deconditioning. However, the natural evolution of physical activity and physical fitness over the course of treatment is unknown. Therefore, the aim of this longitudinal study was to assess fatigue, physical activity, and physical fitness in lymphoma patients before, during, and after treatment. Fatigue was measured with the EORTC-QLQ-C30, physical activity with an accelerometer, and physical fitness with a maximal incremental cycle ergometer test, 6-min walking distance test, and muscle strength measurements. Differences between the three measurement moments and baseline differences between Hodgkin lymphoma and non-Hodgkin lymphoma, early and advanced disease, were analyzed. Twenty-nine patients were included. Functional exercise capacity and quadriceps force were impaired before the start of treatment (86±15 and 82±16 % of predicted value, respectively). Over the course of treatment, significant declines were found in hemoglobin, quadriceps force, handgrip force, and maximal oxygen uptake, while patients reported more fatigue (p values 2) (4 men, 4 women) 18 patients had medical contraindications (9 men, 9 women): - Lymphoma localisation implying risks: 4 - Comorbidities: 4 - Pericardial effusion: 2 - Recent laparatomy: 2 - Hemoptysis: 1 - Mental retardation: 1 - Extreme anaemia: 1 - Hemiplegia: 1 - Vena cava superior syndrome: 1 - Planned stem cell transplantation: 1
Study proposed to 39 patients (31 men, 8 women)
9 patients refused to participate (5 men, 4 women) 1 patients was lost because of logistical problems (1 man)
29 patients included (25 men, 4 women)
respectively). No baseline differences were found between early stage and advanced disease (Table 2).
Over the course of treatment, no significant differences were found for parameters of physical activity (Table 3 and
Table 1 Patient and treatment characteristics
Normally distributed parameters expressed as mean ± SD and nonnormally distributed parameters as median (range) ECOG Eastern Cooperative Oncology Group, HL Hodgkin lymphoma, n number, NHL nonHodgkin lymphoma, SD standard deviation *
p =0.002 HL versus NHL, † p
