Hematopoietic progenitor cells (HPCs) mobilization following high-intensity interval exercise in cancer patients undergoing bone marrow transplantation: preliminary results from a randomized controlled trial

BACKGROUND AND OBJECTIVE: Hematopoietic progenitor cells (HPCs) mobilization is essential for successful bone marrow transplantation but may be impaired in cancer patients due to prior treatments. High-intensity interval exercise (HIIE) has been shown to enhance progenitor cell release in healthy individuals; however, its effects in patients with cancer remain unclear. This study aimed to evaluate the acute effects of HIIE on HPC mobilization in patients with cancer undergoing bone marrow transplantation. METHODS: In this randomized controlled trial (RCT), 20 patients with cancer undergoing bone marrow transplantation were randomly assigned to either an exercise (n = 10) or a control (n = 10) group. To determine peak power, patients in the exercise group performed a graded exercise test. After receiving granulocyte-colony stimulating factor, they performed an HIIE protocol consisting of 12 × 1-min efforts at 100% peak power, followed by 1-min active recovery at 20% peak power. Blood samples were collected before and immediately after exercise and analyzed for catecholamines and CD34 + cells. RESULTS: Data analyses revealed a significant increase in epinephrine, norepinephrine, and CD34 + cells after exercise compared with the control group (p < 0.05). In addition, a positive correlation between epinephrine and CD34 + cells was observed after exercise in the HIIE group. However, CD34 + cells and mononuclear cells did not differ significantly between the two groups (p > 0.05). CONCLUSIONS: HIIE can mobilize HPCs by increasing epinephrine. However, the increased catecholamine levels and CD34 + cells after HIIE did not affect the apheresis products, possibly because of differences in HPCs time courses and homing. CLINICAL TRIAL REGISTRATION: Registration of this trial protocol under the scientific name of "The effect of highintensity interval exercise and training on the mobilization of hematopoietic stem cells in autologous bone marrow transplant patients" has been approved in the Iranian Registry of Clinical Trials on 2023-01-08. The registration reference is IRCT20230101057012N1.