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Nutritional and Physical Exercise Intervention in Older Patients With Malignant Hemopathies

Not Applicable
Conditions
Old Age; Debility
Hematologic Malignancy
Interventions
Other: Nutritional support
Other: Physical exercise
Drug: Hematologic Drug
Registration Number
NCT04057443
Lead Sponsor
Maite Antonio, MD, Phd
Brief Summary

Clinical trial to analyze the impact of nutrition and physical exercise intervention program on the completion of treatment in older patients 70 years or older with malignant hemopathology

Detailed Description

OBJECTIVE:

This study aims to determine wether a geriatric intervention based on an individualized program of physical exercise and nutritional support improves the ability to complete oncological treatment at the doses and time initially planned in patients ≥ 70 years affected by hematological malignancies.

DESIGN:

Prospective, clinical trial, randomized, parallel and open groups.

SETTING:

Patients ≥ 70 years recently diagnosed of malignant hematological pathology in a comprehensive cancer center

INTERVENTION:

All those patients who meet the inclusion criteria and agree to participate, will sign the corresponding informed consent and will be assessed through a CGA (comprehensive geriatric assessment), that includes the performance of a physical condition test (SPPB), and randomized to the study group or control group. Patients in the study group will participate in an intervention program with nutritional support and physical exercise during the period in which they are receiving oncological treatment or for a maximum period of 6 months. The patients of the control group will pass to follow up. All patients, regardless of the branch of study to which they are assigned, will receive the oncological treatment indicated by their doctor and a standard follow-up according to the current care protocols in the center.

DETERMINATIONS:

Main variable: proportion of adherence to treatment calculated as the percentage between the dose administered and the prescribed. Adherence over 80% will be considered acceptable.

Secondary variables: geriatric, nutritional and physical-condition parameters before and after the intervention, quality of life before and after the intervention, toxicity and complications during treatment and response to treatment.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
80
Inclusion Criteria
  • hematological pathology (myelodysplastic syndromes, lymphoproliferative syndromes, multiple myeloma)
  • considered able to practice physical exercise
  • signed informed consent
Exclusion Criteria
  • other hematological pathology
  • considered unable to practice physical exercise

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Intervention groupHematologic DrugPatients in the intervention group will follow the standard treatment and follow-uo according to the clinical protocol of the institution and will participate in an intervention program with physical exercise and nutritional support during the period in which they are receiving oncological treatment or for a maximum period of 6 months.
Control groupHematologic DrugThe patients of the control group will follow the standard treatment and follow-up according to the clinical protocol of the institution.
Intervention groupNutritional supportPatients in the intervention group will follow the standard treatment and follow-uo according to the clinical protocol of the institution and will participate in an intervention program with physical exercise and nutritional support during the period in which they are receiving oncological treatment or for a maximum period of 6 months.
Intervention groupPhysical exercisePatients in the intervention group will follow the standard treatment and follow-uo according to the clinical protocol of the institution and will participate in an intervention program with physical exercise and nutritional support during the period in which they are receiving oncological treatment or for a maximum period of 6 months.
Primary Outcome Measures
NameTimeMethod
Adherence to oncological treatmentChange from baseline and after finishing treatment or 6 months

Percentage between the dose administered and the prescribed.

Secondary Outcome Measures
NameTimeMethod
Risk of vulnerabilityBaseline versus 6 months (end of intervention) versus 12 months

Vulnerable Elders Survey (VES-13) (numeric variable)

Geriatric assessmentBaseline versus 6 months (end of intervention) versus 12 months

Geriatric Assessment in Hematology (GAH scale) (numeric variable)

Nutritional screeningBaseline versus 6 months (end of intervention) versus 12 months

Mini-Nutritional Assessment (MNA) (numeric variable)

Functional capacityBaseline versus 6 months (end of intervention) versus 12 months

Basic activities of daily life (ABVD) - (Barthel scale) and instrumental activities of daily life (IADL) (Lawton-Body scale), fatigue (Borg scale) (numeric variable)

Physical condition screeningChange from baseline versus 6 months (end of intervention) versus 12 months

Short Portable Physical Performance (SPPB) test. Numeric variable.

Physical condition testsBaseline versus 6 months (end of intervention) versus 12 months

Walking test 4 metres, Up-and-go test (seconds)

Body mass indexBaseline versus 6 months (end of intervention) versus 12 months

Weight and height will be combined to report body mass index (BMI) in kg/m2

Anthropometric evaluationBaseline versus 6 months (end of intervention) versus 12 months

Anthropometric evaluation of waist, hip, arm, thigh and leg perimeters (cm).

Body compositionBaseline versus 6 months (end of intervention) versus 12 months

Body mass measured with electrical bioimpedance

Performance of muscular strengthBaseline versus 6 months (end of intervention) versus 12 months

Strength measured by Isometric dynamometry of hands (hand grip) and legs (flex-extension) (KgF)

Functional capacity assessmentChange from baseline versus 6 months (end of intervention) versus 12 months

6-minute walk test to assess functional capacity.

Assessment of lower limbs strenghChange from baseline versus 6 months (end of intervention) versus 12 months

Test to sit and get up in 30 seconds

Average number of exercise sessions completedThrough study completion, an average of 6 months

Number of exercise sessions completed by each participant in the intervention group.

Incidence of adverse effectsThrough study completion, an average of 6 months

Frequency and severity of adverse effects according to CTCAE v4.

Quality of life AssessmentChange from baseline versus 6 months (end of intervention) versus 12 months

Quality of Life Assessment: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ)for old patients with cancer. (EORTC QLQ-ELD14): numeric variable.

Disease progressionChange from baseline and after 2 years

Time to treatment failure, time to disease progression or death from any cause, and time to disease progression

SurvivalChange from baseline and after 2 years

Disease-free survival, overall survival, and cancer-specific survival.

Trial Locations

Locations (1)

Institut Català d'Oncologia

🇪🇸

L'Hospitalet de Llobregat, Barcelona, Spain

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