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Better physical fitness reduces the risk of frailty in patients with chronic lymphocytic leukemia

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Increased levels of exercise could help reduce frailty in patients with the most common form of leukaemia, chronic lymphocytic (CLL), according to new research from the University of Surrey. The discovery of a link between frailty and “good cholesterol” (high-density lipoproteins (HDL)) could help identify those most at risk.

In the first study of its kind, researchers from the University of Surrey and Duke University Medical Center found that higher HDL levels were directly associated with better physical fitness in patients, reducing their risk of frailty. Known factors that increase HDL levels are healthy eating and increased physical activity and exercise.

CLL is a type of cancer associated with a decline in major body systems, which decreases survival rates due to risks of infection, hospitalizations and secondary malignancies. These risks are increased by low physical condition which predisposes patients to higher risks of frailty, which in turn is predictive of poor survival rates in people with CLL.

Dr David Bartlett, Senior Lecturer in Exercise Immunology at the University of Surrey and Assistant Professor in the Department of Medicine at Duke University Medical Center, said:

“Physical decline is more common in people with chronic lymphocytic leukemia than any other blood cancer, suggesting that it is the likely cause of such deterioration. Halting or even slowing this decline physical activity will reduce a patient’s risk of frailty and improve their chances of survival.

“It’s important that we identify those at risk and give them the support they need; however, until now we had no way of knowing that.”

In this unique study, researchers analyzed blood samples from 106 CLL patients and assessed their physical condition by completing a questionnaire and physical performance tests (six-minute walk test, walking speed, weight bearing chair, grip strength and balance tests).

It was also found that higher levels of citrate and lower levels of hemoglobin in the blood were more likely to be found in patients with poor physical health.

The researchers also found that patients who had been living with the disease for many years and those who had received treatment had a higher likelihood of poor aerobic capacity and function, predisposing them to an increased risk of frailty.

High density lipoproteins remove cholesterol and return it to the liver. When its levels are low, cholesterol is used by cancer cells, increasing the risk of developing secondary disease and decreasing the chances of survival.

Exercising is a simple way to increase good cholesterol levels in the body. With this information, we can monitor levels in patients with chronic lymphocytic leukemia and provide support to those who need it.”

Dr David Bartlett, Lecturer in Exercise Immunology, University of Surrey

This study was published in the journal Frontiers in Oncology.


Journal reference:

Sitlinger, A. et al. (2022) Associations of clinical and circulating metabolic biomarkers with low fitness and function in adults with chronic lymphocytic leukemia. Frontiers in oncology.