Influence of a Moderate-Intensity Exercise Program on Early NK Cell Immune Recovery in Pediatric Patients After Reduced-Intensity Hematopoietic Stem Cell Transplantation

Abstract

Introduction: After allogeneic hematopoietic stem cell transplantation (HSCT), NK cell reconstitution, which is crucial for positive outcomes, is dominated by the CD56bright subset with low NK cell cytotoxicity (NKCC) activity. Moderate exercise has been described as a potent NK cell stimulus in adults with cancer. Purpose: To determine the effects of a moderate-intensity exercise program on NK cell recovery early after HSCT and the feasibility of this intervention. Methods: Six children undergoing allogeneic HSCT were randomized to an exercise program (EP) or control (CT) group. The EP group performed a 10-week training combining in-hospital and home-based EP. Results: We observed a significant increase in the posttraining/pretraining ratio of the CD56dim subset (EP = 1.27 ± 0.07; CT = 0.99 ± 0.08; P < .005) of the EP group. The ratio of NKCC was 8 times greater in the EP group. Conclusion: Data suggest that a moderate-intensity EP program performed early after HSCT is feasible and might redistribute the CD56dim/CD56brigh NK cell subset, improving NKCC. The results are still preliminary and must be interpreted with caution.

The effect of an active video game intervention on physical activity, motor performance, and fatigue in children with cancer: a randomized controlled trial

“…Adverse effects were not reported. Our results are partly in discrepancy and partly in line with the earlier findings [19, 20]. Active video gaming has been suggested to improve body coordination in survivors of childhood brain tumors [19] and to be feasible as a part of home-based exercise program in paediatric patients after hematopoietic stem cell transplantation [20].…”

Tailored Exercise during Hematopoietic Stem Cell Transplantation Hospitalization in Children with Cancer: A Prospective Cohort Study

“…Among the innate immune cell subtypes that can be potentially receptive to exercise, the evidence is especially strong for natural killer (NK) lymphocytes, which can show improved cytotoxicity (or ‘killing capacity’) [ 19 ]. Indeed, a moderate-intensity exercise intervention has been proven to increase NK cytotoxic activity in children undergoing HSCT, who are immune-compromised [ 7 ]. Notwithstanding, the evidence on the role of exercise on immune function in childhood cancer is inconclusive [ 20 ].…”

“…There is meta-analytic evidence that exercise improves functional capacity in children and adolescents treated for cancer in general [ 4 ], and undergoing HSCT in particular [ 5 ]. We previously reported preliminary evidence that supervised physical training might be beneficial for the immune system of children with cancer even when performed during the most aggressive phases of treatment [ 6 ] and HSCT-associated hospitalization [ 7 , 8 , 9 ]. We observed an attenuation in the reduction of dendritic cell count in children—most of them with leukemias—who performed physical exercise from the beginning of the HSCT conditioning phase until the end of the neutropenic phase, as compared with their non-exercised controls [ 9 ].…”

Transplant Energize Me Patient Outcome (TEMPO): A Quality Improvement Project that Maintains Functional Mobility in Pediatric Patients Admitted for Allogeneic Hematopoietic Cell Transplantation

“…Specifically, cardiorespiratory fitness, as assessed by measures such as the 6-minute walk test (6MWT), has been shown to Biology of Blood and Marrow Transplantation journal homepage: www.bbmt.org have a stabilizing effect or statistically significant improvements in endurance with the use of exercise intervention during HCT for pediatric patients compared with control subjects from admission to follow-up [11,14]. The assessment of hand grip strength in pediatric patients undergoing HCT has shown similar statistically significant improvements in strength at time of discharge [17].…”