Ellie Miles
Academic and research departments
Section of Sport, Health and Exercise Sciences, School of Biosciences.About
My research project
Investigating and modifying the physiological processes associated with premature frailty and physical dysfunction in adults with chronic lymphocytic leukaemiaChronic Lymphocytic Leukaemia (CLL) is the most prevalent adult Leukaemia in the western world, predominantly affecting the older population. It is a disease that differs from other cancers in that most have a period of no treatment lasting years before treatment is initiated. Due to age-related and cancer-specific complications, individuals with CLL are at an increased risk of frailty, often characterised physiologically by physical dysfunction. Exercise may improve physical function in solid tumours and other haematological malignancies. However, only one study has assessed the role of exercise training specifically within CLL, identifying the feasibly of an exercise intervention within this population. Therefore, the aims for this project are to explore the physiological processes associated with premature frailty within Chronic Lymphocytic Leukemia, and to identify how these processes may change with the addition of supervised and semi-supervised exercise. I hope that the findings from my project will provide further insight into the role of exercise within this clinical population and provide guidance to practitioners when advising patients on exercise.
Supervisors
Chronic Lymphocytic Leukaemia (CLL) is the most prevalent adult Leukaemia in the western world, predominantly affecting the older population. It is a disease that differs from other cancers in that most have a period of no treatment lasting years before treatment is initiated. Due to age-related and cancer-specific complications, individuals with CLL are at an increased risk of frailty, often characterised physiologically by physical dysfunction. Exercise may improve physical function in solid tumours and other haematological malignancies. However, only one study has assessed the role of exercise training specifically within CLL, identifying the feasibly of an exercise intervention within this population. Therefore, the aims for this project are to explore the physiological processes associated with premature frailty within Chronic Lymphocytic Leukemia, and to identify how these processes may change with the addition of supervised and semi-supervised exercise. I hope that the findings from my project will provide further insight into the role of exercise within this clinical population and provide guidance to practitioners when advising patients on exercise.
Publications
Background Chronic lymphocytic leukaemia (CLL) has a heterogeneous lifelong course. While some patients never require treatment, most experience intermittent periods of active monitoring with other time points in active treatment. Most patients experience significant symptoms which negatively impact their quality of life (QoL). Although physical activity and exercise may help manage symptoms, it is unclear what disease-related factors drive the physical inactivity observed in people with CLL. Methods This study explored physical activity among people with CLL and assessed differences and relationships in treatment stage, symptoms, quality of life, and preferences for physical activity using an online questionnaire. Results A total of 128 individuals with CLL [66 M/62F: mean age 67 ± 9.1 years (range 38–91 years)] completed the questionnaire. Those who are being/have been treated (N = 55) exhibited worse QoL (p = 0.018) and lower engagement in higher levels of physical activity (p = 0.045) when compared to their treatment naïve (N = 73) counterparts. Both groups had similar symptomology, with fatigue (∼77%) and insomnia (∼55%) being the most reported and associated with less likelihood of being physically active. Physically active participants reported better QoL (p = 0.020), physical functioning (p = 0.003) and role functioning (p = 0.020) as well as lower levels of fatigue (p = 0.036), pain (p = 0.017) and symptom burden (p = 0.026) compared to those who were insufficiently active. Although 79% of respondents wanted to engage in exercise programs for their CLL, 70% reported never receiving exercise guidance from their healthcare professionals. Conclusion These findings highlight a significant need for targeted interventions to increase physical activity, likely improving QoL, in people with CLL. Furthermore, there is considerable interest from the CLL community in receiving exercise guidance; however, factors such as treatment status and symptomology should be considered when developing CLL-specific exercise programs.