Restricting calories and nutrients to change chemotherapy effectiveness for acute lymphoblastic leukemia

This study aimed to investigate if restricting calories and nutrients from diet and exercise could change chemotherapy effectiveness in patients with B-cell acute lymphoblastic leukemia (ALL). 

This study concluded that restricting calories/nutrients via diet and exercise changed chemotherapy effectiveness and improved outcomes for these patients.  

In patients with B-cell ALL (B-ALL), being overweight or obese (OW/OB) during treatment is associated with resistance to chemotherapy (chemoresistance). Minimal residual disease (MRD) is used to quantify chemoresistance. MRD is the small number of cells that remain during or after treatment.  

Animal studies showed that reducing calories in diet improved the survival after chemotherapy. However, it was unknown if restricting calories and nutrients from diet and exercise could lessen gains in fat mass (FM) and reduce MRD after chemotherapy in patients with B-ALL. 

This study involved 40 patients with newly diagnosed B-ALL. These patients had a 20% or more reduction in daily calories through diet and exercise. These patients were compared to a group of 80 patients from another study who did not have caloric restriction during chemotherapy (control group). The outcomes measured were fat mass (FM) gain, MRD greater than or equal to 0.01%, and adherence to the intervention. 

Overall, the average FM was not significantly reduced in the intervention trial compared to the control group. However, OW/OB patients in the intervention group gained significantly less FM (1.5%) compared to the OW/OB patients in the control group (9.7%).  

At the end of chemotherapy, the caloric restriction was associated with a significant reduction in the risk of MRD (by 70%). Also, the caloric restriction intervention was associated with an 84% lower risk of detectable MRD compared to the control group. 

92% of patients had a caloric deficit during the study. Adherence to diet was higher than adherence to exercise.

This study concluded that restricting calories/nutrients via diet and exercise is feasible, reduces fat gain in OW/OB patients, and improves disease response for patients with B-ALL.  

The number of participants was small. The control group was from a different trial, therefore the comparison is not ideal. Further randomized studies are needed.

Please consult your physician before restricting calories and physical exercise during chemotherapy.