Prior cancer therapy does not impact T-lymphocytes and physical function in adults with chronic lymphocytic leukemia: results from the HEALTH4CLL pilot study
Authors: LaVoy Emily , Crane Justin , Gordon Max , Markofski Melissa , Simpson Richard , Lee Che , Fares Sara , Basen-Engquist Karen , Ferrajoli Alessandra 
Published: May 2023

Physical activity (PA) interventions may slow disease progression and improve outcomes, including increased physical function and improved immune profile in patients with chronic lymphocytic leukemia (CLL). However, whether prior cancer therapy impacts intervention-related change in physical function or immune profile in CLL patients is unknown. The objective of this study was to compare physical function and T cell phenotypes before and after a 16-week PA intervention in patients who had received prior CLL directed therapy to patients who had not. We hypothesized that patients who had received prior therapy would exhibit fewer improvements in physical function and T cell profile compared to those who had not received therapy. Methods: Patients with CLL (N=24, 12 no prior therapy) were entered into a 16-week exercise training program consisting of at-home aerobic and/or resistance exercise with remote coaching and dietary counseling. Physical function measures and blood samples were collected at baseline and 16-weeks. T cell subsets were identified in cryopreserved peripheral blood mononuclear cells via flow cytometry. Differences in physical function and T cell subsets between groups (prior therapy vs no prior therapy) were investigated via Mann-Whitney tests; p<.05 was accepted as significant. Results: Measures of physical function did not differ between groups at baseline (pre) or post-intervention (post), nor did they differ in change (Δ) in physical function (6min walk test: Pre U=57, Post U=61, Δ U=75; 30sec sit-to-stand: Pre U=50.5, Post U=47.5, Δ U=72.5; eight-foot timed up & go: Pre U=83, Post U=89, Δ U=64.5; grip strength: Pre U=81, Post U=102 Δ U=55.5; all p>.05). Groups did not differ in T cell profile at baseline, post-intervention, nor in change in T cell profile (PD1+HLADR+ CD4+ T cells: Pre U=59.5, Post U=70, Δ U=74; PD1+HLADR+ CD8+ T cells: Pre U=74, Post U=82, Δ U=92.5; CD4:CD8 ratio: Pre U=59, Post U=48, Δ U=52.5; all p>.05). Summary and conclusions: Contrary to our hypothesis, these results indicate that adult patients with CLL who participate in a 16-week PA intervention may experience similar intervention effects on physical function and T cell profile regardless of prior treatment with CLL directed therapies. However, results require replication in a larger sample size. The HEALTH4CLL study is supported by the Center for Energy Balance in Cancer Prevention and Survivorship at the University of Texas MD Anderson Cancer Center, CLL Global Research Foundation, and generous philanthropic continuations to the University of Texas MD Anderson Cancer Center Moon Shots Program. Funding for this project also provided by a CLASS Research Project Grant from the University of Houston to EL, MM, and RS. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.