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Open Access Study protocol

EXERCISE in pediatric autologous stem cell transplant patients: a randomized controlled trial protocol

Carolina Chamorro-Viña1, Gregory MT Guilcher236, Faisal M Khan5, Karen Mazil27, Fiona Schulte2, Amanda Wurz1, Tanya Williamson1, Raylene A Reimer13 and S Nicole Culos-Reed134*

Author affiliations

1 Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada

2 Section of Pediatric Oncology, Alberta Children’s Hospital, Calgary, Canada

3 Faculty of Medicine, University of Calgary, Calgary, Canada

4 Department of Psychosocial Resources, Tom Baker Cancer Centre, Calgary, Canada

5 Department of Pathology & Laboratory, Faculty of Medicine, University of Calgary, Heritage Medical Research, 3300 Hospital Drive NW . Room 269, Calgary, Canada

6 Division of Pediatric and Oncology, Alberta Children’s Hospital, 2888 Shaganappi Trail NW, Calgary, AB T3B 6A8, Canada

7 Hematology, Oncology, Transplant Program, Alberta Children’s Hospital, 2888 Shaganappi Trail NW44, Calgary, AB T3B 6A8, Canada

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Citation and License

BMC Cancer 2012, 12:401  doi:10.1186/1471-2407-12-401

Published: 10 September 2012

Abstract

Background

Hematopoietic stem cell transplantation is an intensive therapy used to improve survivorship and cure various oncologic diseases. However, this therapy is associated with high mortality rates and numerous negative side-effects. The recovery of the immune system is a special concern and plays a key role in the success of this treatment. In healthy populations it is known that exercise plays an important role in immune system regulation, but little is known about the role of exercise in the hematological and immunological recovery of children undergoing hematopoietic stem cell transplant. The primary objective of this randomized-controlled trial (RCT) is to study the effect of an exercise program (in- and outpatient) on immune cell recovery in patients undergoing an autologous stem cell transplantation. The secondary objective is to determine if an exercise intervention diminishes the usual deterioration in quality of life, physical fitness, and the acquisition of a sedentary lifestyle.

Methods

This RCT has received approval from The Conjoint Health Research Ethics Board (CHREB) of the University of Calgary (Ethics ID # E-24476). Twenty-four participants treated for a malignancy with autologous stem cell transplant (5 to 18 years) in the Alberta Children’s Hospital will be randomly assigned to an exercise or control group. The exercise group will participate in a two-phase exercise intervention (in- and outpatient) from hospitalization until 10 weeks after discharge. The exercise program includes strength, flexibility and aerobic exercise. During the inpatient phase this program will be performed 5 times/week and will be supervised. The outpatient phase will combine a supervised session with two home-based exercise sessions with the use of the Wii device. The control group will follow the standard protocol without any specific exercise program. A range of outcomes, including quantitative and functional recovery of immune system, cytokine levels in serum, natural killer (NK) cells and their subset recovery and function, and gene expression of activating and inhibitory NK cell receptors, body composition, nutrition, quality of life, fatigue, health-related fitness assessment and physical activity levels will be examined, providing the most comprehensive assessment to date.

Discussion

We expect to find improvements in immunological recovery and quality of life, and decreased acquisition of sedentary behavior and fitness deconditioning. The comprehensive outcomes generated in this RCT will provide preliminary data to conduct a multisite study that will generate stronger outcomes.

Trial registration

Gov identification # NCT01666015

Keywords:
Pediatric; Hematopoietic stem cell transplant; Cancer; Exercise; Quality of life; Immune system; Physical activity levels