Aerobic or resistance exercise done at home by patients with chronic lymphocytic leukemia (CLL) increased the CD4:CD8 T-cell ratio, according to a report in the European Journal of Haemotology. This change in T-cell proportions corresponded with an improvement in both physical functioning and fatigue.

In the study, 24 patients with CLL participated in a 16-week intervention of aerobic or resistance exercise performed in their home. T-cell phenotype was evaluated at baseline and 16 weeks.

Leisure-time physical activity was assessed using the Godlin Leisure Time Physical Activity Questionnaire and general physical function by the Patient-Reported Outcome Measurement Information System-Physical Functioning (PROMIS PF) tool. The Functional Assessment of Cancer Therapy-Fatigue (FACT-F) subscale was used to evaluate fatigue.

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At baseline, the mean age was 63 and 67% of patients were female. The mean baseline weight was 78.36 kg, which decreased to 76.70 kg at week 16; mean body mass index was 27.80 and 27.40 kg/m2, respectively. There were 38% of patients who had received 1 or more prior lines of therapy and 50% of patients had not yet received any treatment.

Baseline fatigue was significantly associated with lower CD8-positive T cells (P =.03). Lower levels of PD1-positive/CD4-positive T cells was significantly associated with cardiovascular fitness as measured by the 8-foot timed up and go test (P =.01) and 6-minute walk test (P =.02) and strength as measured by the 30-secong arm curl on the right (P =.01) and left (P =.04) sides.

The exercise intervention resulted in an improvement in the 30 second sit-to-stand repetitions (P =.03), but not the 30 second arm curl repetitions in either arm, the 6-minute walk test, the 8-foot timed up and go test, or grip strength.

However, compared with baseline, the median Godlin leisure-time physical functioning score improved by 14.61 (P <.01) and the median PROMIS PF T-score improved by 2.92 (P =.04). Fatigue, as measured by the FACT-F, also improved by 6.71 (P <.001).

The improvement in fatigue was associated with changes in T-cell phenotype. There was a significant decrease in T cells that were HLADR-positive/CD4-positive (τ=-0.37; P =.01) and HLADR-positive/PD1-positive/CD4-positive (τ=-0.37; P =.01).

“This intervention increased leisure-time physical activity and decreased fatigue in CLL patients,” the authors concluded. “These changes corelated with an increased CD4:CD8 T-cell ratio and reduced proportion of T-cell subsets previously associated with poor outcomes in CLL patients.”


Crane AC, Gordon MJ, Basen-Engquist K, et al. Relationships between T-lymphocytes and physical function in adults with chronic lymphocytic leukemia: Results from the HEALTH4CLL pilot study. Eur J Haematol. Published online March 22, 2023. doi: 10.1111/ejh.13958