Physical activity and physical fitness in lymphoma patients before, during, and after chemotherapy: a prospective longitudinal study.

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 < 0.016). Fatigue was significantly correlated with hemoglobin (r = -0.49), physical activity (r = 0.81), and physical functioning (r = -0.44). Large interindividual variations were found. The present study partially confirmed the hypothesized vicious circle between fatigue, physical inactivity, and deconditioning. Further research with larger samples and longer follow-up is needed to identify factors associated with individual variation in the evolution of fatigue, physical activity, and physical fitness.

Physical activity, physical fitness and the effect of exercise training interventions in lymphoma patients: a systematic review.

Fatigue is one of the most common and most distressing problems in lymphoma patients. A vicious circle is presumed between fatigue, physical activity and physical fitness. It is plausible that an exercise training program would be effective in reducing fatigue, by breaking this vicious circle. The purposes of this review are to provide an overview of the literature on physical activity and physical fitness in lymphoma patients before, during and after anticancer treatment, and to summarise the literature on exercise training interventions in lymphoma patients. We conducted a search for studies reporting on physical activity, physical fitness or the effect of exercise training in lymphoma patients. A total of 13 articles were selected. Due to a small number of articles and methodological issues, it was not possible to make final conclusions. The results indicated that 21 % to 29 % of lymphoma survivors meet the American College of Sports Medicine public health guidelines for physical activity. Maximal exercise capacity was decreased before treatment, especially in patients with advanced disease, and was close to normal during and/or after treatment. Lower levels of physical activity as well as lower physical fitness seemed to be associated with more symptoms of fatigue. Aerobic exercise training interventions seemed to be feasible and safe and had positive effects on cardiorespiratory fitness, fatigue and self-reported physical functioning. Further research is needed to examine physical activity and physical fitness in a longitudinal, objective way in large samples and to examine the effect of exercise training in lymphoma patients.

Physical activity and risk of lymphoma: a meta-analysis.

BACKGROUND: Physical activity has a protective effect on some types of cancer. The aim of the present meta-analysis was to explore the literature on the association between physical activity and risk of lymphoma. METHODS: A meta-analysis was conducted for cohort and case-control studies examining the association between self-reported physical activity and risk of lymphoma. Depending on statistical heterogeneity, a random or fixed effects model was used to estimate the summary OR and corresponding 95% confidence interval (CI). RESULTS: Seven case-control studies and 5 cohort studies were included. When data from both study designs were combined, no significant influence of physical activity on risk of lymphoma was found (pooled OR = 0.90; 95% CI: 0.79-1.02; P = 0.10). Subgroup analysis revealed a significant protective influence of physical activity on risk of lymphoma in case-control studies (pooled OR = 0.81; 95% CI: 0.68-0.96; P = 0.02). In contrast, cohort studies, which have a higher level of evidence than case-control studies, confirm the results of the primary meta-analysis (pooled OR = 1.02; 95% CI: 0.88-1.19; P = 0.76). A subsequent subgroup analysis found no significant differences between results for Hodgkin lymphoma and non-Hodgkin lymphoma (χ(2) = 0.16; P = 0.69), nor between results for recreational and occupational activities (χ(2) = 1.01; P = 0.31). CONCLUSIONS: Epidemiologic research indicates no significant influence of physical activity on risk of lymphoma. IMPACT: Future research should examine the association between sedentary behavior and risk of lymphoma and investigate the dose-response and timing effect of physical activity on risk of lymphoma.