Diet, Exercise With Chemotherapy Leads to Increased Survival in Youth With Leukemia

April 7, 2021
Jill Murphy, Associate Editor

According to previous studies, youth who are obese when they begin chemotherapy are more than twice as likely to have remaining cancer cells after 1 month of treatment compared to their lean counterparts.

Research conducted at the Cancer and Blood Disease Institute at Children’s Hospital Los Angeles indicates that modest changes in diet and exercise can greatly increase survival in youth treated for acute lymphoblastic leukemia, the most common childhood cancer.

“To our knowledge, this is the first study to show that by limiting calories and increasing exercise we can make chemotherapy more effective in eliminating leukemia cells within the first month of therapy, decreasing the chances of disease relapse in children and adolescents,” said principal investigator Etan Orgel, MD, MS, director of the Medical Supportive Care Service in the Cancer and Blood Disease Institute at Children’s Hospital Los Angeles, in a press release.

According to previous studies, youth who are obese when they begin chemotherapy are more than twice as likely to have remaining cancer cells after 1 month of treatment compared to their lean counterparts. The research team worked with registered dietitians and physical therapists who created personalized diet and exercise plans for 40 patients between 10 and 21 years of age with newly diagnosed leukemia.

The investigators found that patients who reduced their caloric intake by at least 10% and began a modest exercise regimen beginning at diagnosis were approximately 70% less likely to have remaining leukemia cells in their bone marrow 1 month after beginning chemotherapy compared to previously treated patients who did not participate in the diet and exercise intervention.

“This is proof of concept that it is possible to increase the effectiveness of chemotherapy without adding other medications and their potential side effects,” Orgel said in a press release. “This short-term intervention is inexpensive and easily available to providers and families everywhere.”

In addition, the investigators found that by limiting fat, patients had decreased insulin resistance as well as increased levels of adiponectin, a metabolic hormone associated with glucose regulation. Identification of these potential biomarkers paves the way to using this intervention to impact other types of cancer, according to the study authors.

“Changing diet and exercise made the chemotherapy work better—that’s the big news of this study. But we also need to figure out how,” said Steven Mittelman, MD, PhD, chief of Pediatric Endocrinology at UCLA Mattel Children’s Hospital and member of UCLA’s Jonsson Comprehensive Cancer Center, in a press release. “Understanding the biological changes responsible for this effect will help us make these interventions even better.”

REFERENCE

Diet + exercise + chemo = increased survival in youth with leukemia. Children’s Hospital Los Angeles. Published April 1, 2021. Accessed April 2, 2021. https://www.chla.org/press-release/diet-exercise-chemo-increased-survival-youth-leukemia