Effects of exercise-based interventions on health related quality of life of patients and survivors affected by hematological malignancies

Purpose: Adults affected by hematological malignancies often face treatment-related side effects that could negatively impact their health-related quality of life (HRQoL). In this setting, the potential beneficial role of exercise remains under-investigated. This system- atic review and meta-analysis aim to explore the effects of exercise- based interventions on HRQoL of patients with hematological tumors during and after the completion of treatments.\r\nMethods: The systematic review was registered in PROSPERO (CRD42022347819). PubMed, Web of Science, and Scopus databases were systematically screened, and randomized clinical trials com- paring EX to UC in adults with hematological malignancies were included. The standardized mean differences (SMD) between the EX and UC changes in the HRQoL domains were analyzed by means of random-effects meta-analyses using the package of the software R (version 4.0.4), with a = 0.05. The SMD were interpreted as negli- gible (B 0.2), small (0.2–0.5), medium (0.5–0.8), large ([ 0.8). Results: A total of 1091 articles were analyzed and 7 reported suf- ficient information to compute the SMD between the EX and UC changes in HRQoL domains. Among the 494 participants included, 456 were receiving anticancer therapies while 38 were survivors during the intervention. The majority had acute myeloid leukemia (49%). Regarding EXs, 6 studies proposed a combined aerobic and resistance training for a period ranging from 1 to 12 weeks, whereas one study proposed aerobic training for approximately 4 weeks. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ C30) was used to assess HRQoL in all the studies. The SMD (mean [95% CI]) between EX and UC showed non-significant negligible differences in global health status (0.043 [-0.215; 0.301]), physical functioning (0.119 [-0.180; 0.417]), role functioning (-0.004 [-0.228; 0.219]), emotional functioning (0.200 [-0.070; 0.471]), and social functioning (0.054 [-0.170; 0.278]), whereas there was a significant (0.046) small difference in cognitive functioning (0.277 [0.007; 0.547]).\r\nConclusions: Our preliminary results show the positive effect of exercise-based interventions solely in improving cognitive function- ing, with contrasting results in the selected studies in the other HRQoL domains. Therefore, future research analyzing the method- ological and clinical factors affecting the efficacy of exercise-based interventions are needed to improve their efficacy.