Effects of aerobic exercise training in anemic cancer patients receiving darbepoetin alfa: a randomized controlled trial.


Journal Article

BACKGROUND: Anemia in patients with solid tumors is a common problem that is associated with impaired exercise capacity, increased fatigue, and lower quality of life (QoL). Erythropoiesis-stimulating agents (ESAs) have been shown to improve these outcomes; however, it is unknown if additional benefits can be achieved with aerobic exercise training. METHODS: We conducted a single-center, prospective, randomized, controlled trial in 55 mild-to-moderately anemic patients with solid tumors. Patients were randomized to either darbepoetin alfa alone (DAL, n = 29) or darbepoetin alfa plus aerobic exercise training (DEX; n = 26). The DEX group performed aerobic exercise training three times per week at 60%-100% of baseline exercise capacity for 12 weeks. The primary endpoint was QoL assessed by the Functional Assessment of Cancer Therapy-Anemia scale. Secondary endpoints were fatigue, cardiorespiratory fitness (VO(2peak)), hemoglobin (Hb) response, and darbepoetin alfa dosing. RESULTS: Intention-to-treat analyses indicated significant improvements in QoL and fatigue in both groups over time but there were no between-group differences. The DEX group had a significantly greater VO(2peak) than the DAL group (mean group difference, +3.0 ml/kg per minute; 95% confidence interval, 1.2-4.7; p = .001) and there were borderline significant differences in favor of the DEX group for Hb response and darbepoetin alfa dosing. CONCLUSIONS: Aerobic exercise training did not improve QoL or fatigue beyond the established benefits of DAL but it did result in favorable improvements in exercise capacity and a more rapid Hb response with lower dosing requirements. Our results may be useful to clinicians despite the more recent restrictions on the indications for ESAs.

Full Text

Cited Authors

  • Courneya, KS; Jones, LW; Peddle, CJ; Sellar, CM; Reiman, T; Joy, AA; Chua, N; Tkachuk, L; Mackey, JR

Published Date

  • September 8, 2008

Published In

Volume / Issue

  • 13 / 9

Start / End Page

  • 1012 - 1020

PubMed ID

  • 18779540

Pubmed Central ID

  • 18779540

Electronic International Standard Serial Number (EISSN)

  • 1549-490X

International Standard Serial Number (ISSN)

  • 1083-7159

Digital Object Identifier (DOI)

  • 10.1634/theoncologist.2008-0017


  • eng