Vigorous Exercise Boosts Effectiveness of CLL Treatment with Rituximab: Study

New research shows that a burst of vigorous-intensity exercise could aid the efficacy of rituximab, an antibody therapy that is commonly used to treat chronic lymphocytic leukemia (CLL), new research shows. Scientists at the Universities of Birmingham and Bath, in the United Kingdom, have published a study in the journal Brain, Behavior, and Immunity, which looked at a participant group of 20 people with CLL.They had not received any cancer treatment before, and took part in a round of cycling for 20 to 30 minutes as part of the study. 

In combination with rituximab, which attaches to a protein on cancer cells that helps the natural killer cells identify and kill them, the anti-cancer cells were twice as effective in blood samples taken immediately after exercise. The mobilisation of CD5+CD19+ CLL cells and their subsets in response to cycling exercise in this study is a novel finding not previously described. CLL cells possess a similar phenotype to that of healthy B-cells (e.g., CD19) and these cells may increase up to 100% following a bout of vigorous cycling in healthy humans. 

Doctors who reviewed this study say that this is a small pilot study of 20 patients in a controlled situation restricted to exercise in a set fashion with some intriguing biologic findings of exercise activation NK cell activity and Rituxan [brand name for rituximab] induced CLL killing.However, this data needs to be validated in larger studies with a more heterogeneous patient population. It is also not clear how this finding impacted clinical outcome or whether it did have any bearing on response to therapy, or disease stability. 

This study does not demonstrate that exercise impacted the clinical trajectory of CLL, merely that it induced enhanced Rituxan directed CLL cytotoxicity. There are no randomized clinical trials in the cancer space that I know of that use exercise as an intervention and have demonstrated an improvement in clinical outcome. The patient who will be able to do vigorous exercise maybe has a different immune system compared to people who don’t.  

While many cancer treatments, especially those that involve chemotherapy or surgery, can cause extreme fatigue that can prevent physical activity, there is growing evidence that exercise can stimulate immune cells. Researchers recommend being active and exercising since there’s a body of evidence that exercise during cancer treatment can help the immune system and now more than ever before one can understand the role of the immune system in fighting cancer. In fact a lot of the newer therapies for cancer are immune-based therapies that help activate the immune system to fight cancer.