A new study of patients with chronic lymphocytic leukemia (CLL) underscored the critical role of physical activity in improving quality of life and managing symptoms. However, a lack of tailored programs and clinical guidance has left a gap in care, representing a significant opportunity for managing the disease.1
The findings, published in eJHaem, showed that patients who engaged in regular physical activity had significantly better quality of life (QOL) and reduced symptom burden, though only approximately 1 in 4 patients get the recommended amount of physical activity.
Despite the benefits associated with adequate physical function in CLL, 70% of respondents said they had never received any physical activity advice from a doctor. | Image Credit: kieferpix – stock.adobe.com.jpg
Researchers in the United Kingdom surveyed 128 patients with CLL to assess physical activity levels, symptom severity, QOL, and preferences for exercise program delivery. The group included both treatment-naïve patients and those receiving treatment.
Only 24.6% of respondents met recommended physical activity guidelines, defined as more than 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity activity per week. Treatment-naive patients were more likely to meet these guidelines and reported nearly double the minutes of moderate-to-vigorous activity compared with their treated counterparts.
Patients who were physically active reported higher global health scores and significantly better physical and role functioning. Conversely, those classified as insufficiently active experienced greater fatigue (P = .036), pain (P = .017), and overall symptom burden (P = .026).
The researchers highlighted the importance of these findings for patients with CLL given the high prevalence of fatigue and frailty among the population. They wrote, “Compared to solid cancers, patients with hematologic malignancies have lower physical function, higher levels of fatigue, and an increased risk of frailty. Approximately 60% to 70% of older adults with CLL are classified as either pre-frail or frail, a striking contrast to the 15% to 30% frailty observed in the general older population.”
Despite the benefits associated with adequate physical function, 70% of respondents said they had never received any physical activity advice from a doctor. Still, nearly 80% expressed interest in joining an exercise program designed for people with CLL.
When asked about program preferences, participants overwhelmingly supported supervised exercise sessions led by cancer-trained physiotherapists or exercise physiologists. Group sessions with other CLL patients or individuals with cancer were favored over public or general population classes. Safety, convenience, and cost were major considerations, with strong preferences for virtual programs or those delivered in community clinics rather than hospital settings.
While previous studies have explored the impact of physical activity on QOL among patients with CLL,2 this new study is one of the first to link exercise behavior with symptom load and QOL across different treatment stages in CLL.1 The authors argued that current “one-size-fits-all” physical activity recommendations fail to meet the needs of this population. They advocated for the development of CLL-specific exercise guidance that accounts for treatment status, symptom burden, and individual preferences.
“Currently, most physical activity and exercise approaches employ a ‘cookie-cutter’ approach and try to fit everyone into one model. We show that several factors, including treatment status and symptomology, should be considered when creating CLL-specific programs,” described the researchers.
Across both treatment groups, fatigue was the most commonly reported symptom, affecting over 75% of participants. Insomnia and stress were also highly prevalent, affecting more than half of patients. Treated patients were more likely to experience severe fatigue (P = .081) and report higher levels of pain and reduced physical functioning.
Multivariable analysis identified several factors significantly associated with reduced physical activity, including fatigue (OR, 0.979; 95% CI, 0.960-0.998; P = .033), insomnia (OR, 0.983; 95% CI, 0.96-0.997; P = .017), dyspnea (OR, 0.978; 95% CI, 0.958-0.999; P = .036), pain (OR, 0.981; 95% CI, 0.96-1.001; P = .066), and lower self-reported physical condition (OR, 0.967; 95% CI, 0.945-0.990; P = .005). Importantly, both treatment status and physical condition independently predicted whether individuals met activity guidelines.
References
1. Milles EE, Nicoli JL, Fowler H, et al. Physical activity symptoms, quality of life and exercise program preferences in people with chronic lymphocytic leukaemia. eJHaem. 2025;6(4):e70100. doi:10.1002/jha2.70100
2. Mellilo G. Physical activity improves quality of life, fitness among older adults with CLL. AJMC®. April 15, 2023. Accessed July 18, 2025. https://www.ajmc.com/view/physical-activity-improves-quality-of-life-fitness-among-older-adults-with-cll