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Diet, Exercise Intervention Explored in Children With B-ALL

THURSDAY, April 8, 2021 -- For children with B-cell acute lymphoblastic leukemia (B-ALL), a diet and exercise intervention might improve disease response, according to a study published online April 1 in Blood Advances.

Etan Orgel, M.D., from the Cancer and Blood Disease Institute at the Children's Hospital Los Angeles, and colleagues enrolled 40 patients aged 10 to 21 years newly diagnosed with B-ALL in the Improving Diet and Exercise in ALL trial and compared them to recent historical controls (80 participants). The intervention was intended to achieve caloric deficits ≥20 percent during induction, reduce fat intake and glycemic load, and increase activity. Fat mass (FM) gain, minimal residual disease (MRD; ≥0.01 percent), and adherence/feasibility were assessed as trial end points.

The researchers found that the intervention did not significantly reduce median FM change from baseline overall (+5.1 versus +10.7 percent; P = 0.13), but in a stratified analysis, there was a benefit for overweight/obese participants (+1.5 versus +9.7 percent; P = 0.02). The intervention significantly reduced the risk for MRD after adjustment for prognostic factors (odds ratio, 0.30; 95 percent confidence interval, 0.09 to 0.92; P = 0.02). The adherence and feasibility thresholds were exceeded (≥75 percent of overall diet and ≥80 percent completed visits, respectively). Circulating adiponectin was increased, and insulin resistance decreased with the intervention.

"This is the first trial to test a diet-and-exercise intervention to improve treatment outcomes from a childhood cancer," Orgel said in a statement. "This is an exciting proof-of-concept, which may have great implications for other cancers as well."

One author disclosed financial ties to Servier Pharmaceuticals.

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