Impact of Exercise on Hemophilia.

Sports and strenuous exercise have traditionally been discouraged for people with hemophilia (PWH) because of the perceived risk of bleeding. In this review, studies investigating the pros and cons of exercise are presented, and although most studies are of low validity, the randomized trials that do exist tell us that PWH benefit from exercise in terms of improved muscular function, endurance, and quality of life and that increased bleeding does not seem to be an issue. The authors also review the studies that have analyzed the current physical status of PWH compared with the general population in different countries. Finally, they review the current knowledge on the effect of exercise on specific coagulation factors as well as on global coagulation and demonstrate that exercise increases factor VIII levels in healthy persons, all persons with hemophilia B (HB) and in persons with mild and moderate hemophilia A (HA). Further, the authors did not find any evidence that the global coagulation capacity, measured with thrombin generation or thromboelastographic methods, increases after exercise in severe HA or HB.

Author Correction: Mutational and putative neoantigen load predict clinical benefit of adoptive T cell therapy in melanoma.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Mutational and putative neoantigen load predict clinical benefit of adoptive T cell therapy in melanoma.

Adoptive T-cell therapy (ACT) is a highly intensive immunotherapy regime that has yielded remarkable response rates and many durable responses in clinical trials in melanoma; however, 50-60% of the patients have no clinical benefit. Here, we searched for predictive biomarkers to ACT in melanoma. Whole exome- and transcriptome sequencing and neoantigen prediction were applied to pre-treatment samples from 27 patients recruited to a clinical phase I/II trial of ACT in stage IV melanoma. All patients had previously progressed on other immunotherapies. We report that clinical benefit is associated with significantly higher predicted neoantigen load. High mutation and predicted neoantigen load are significantly associated with improved progression-free and overall survival. Further, clinical benefit is associated with the expression of immune activation signatures including a high MHC-I antigen processing and presentation score. These results improve our understanding of mechanisms behind clinical benefit of ACT in melanoma.

The effect of Nordic Walking on joint status, quality of life, physical ability, exercise capacity and pain in adult persons with haemophilia.

Nordic Walking is an exercise form requiring significant energy consumption, but where the use of poles minimizes the risk of injury. The aim of this pilot study was to examine the effect of 3 months of Nordic Walking on males (>40 years of age) with haemophilia, regarding joint function (Haemophilia Joint Health Score), physical ability (Haemophilia Exercise Project - Test-Questionnaire), exercise capacity (6-min walking test), pain (visual analogue scale) and quality of life (the Swedish version of The Short Form Health Survey, SF-36). Pre-interventional and post-interventional scores of above-mentioned parameters were analysed, using Wilcoxon Signed Ranks Test. Eleven participants were recruited to the study. Statistically significant improvements were observed in physical ability (P value: 0.01) and body perception (P value: 0.02). The intervention did not increase number of bleedings or factor consumption. This is the first study ever evaluating Nordic Walking in persons with haemophilia. Our results suggest that Nordic Walking is safe and efficient, also in patients with haemophilic arthropathy.