Feasibility of Symptom Profiling and a 9-Week Exercise Intervention on Pediatric Cancer Patients With Lymphoblastic Leukemia and Lymphoma

BACKGROUND: Prior research has demonstrated that exercise interventions in pediatric acute lymphoblastic leukemia (ALL) (B or T cell) and lymphoblastic lymphoma (LBL) patients populations can be feasible, acceptable, and effective across various stages of the cancer continuum (Bılazer et al., 2025; Esbenshade et al., 2014; Gohar et al., 2011; Masoud et al., 2023; San Juan et al., 2007). However, the feasibility and impact of implementing such interventions during the induction phase of chemotherapy remain largely unknown. METHODS: The present study addressed this gap by evaluating a hybrid exercise model integrated with weekly symptom profiling during this clinically intensive period. Feasibility of this study is based on the following criteria: retention, adherence, compliance, tolerance, and outcome capture. RESULTS: Two pediatric ALL patients were enrolled and completed all aspects of the study. The study was deemed to be partially feasible meeting three of the five predefined criteria; 100% retention, 33% adherence, 97% compliance, 63% tolerance, and 88% outcome capture. Symptom profiling variables had mixed results with large to moderate improvements in select HRQOL domains, small to moderate declines in body composition, and large improvements in several physical function measures. DISCUSSION: These preliminary findings suggest that this approach is mostly feasible and can be incorporated within a clinical setting, as evidenced by strong retention, compliance, and outcome capture. However, adherence and tolerance emerged as key challenges, indicating that modifications to improve consistent participation and optimize exercise dosing are needed prior to initiating larger randomized efficacy trials. Despite low adherence and tolerance, potential improvements in select physical function and psychosocial outcomes were observed, providing preliminary support of beneficial effects of the intervention even at a relatively low exercise dose, whereas body composition outcomes were largely unchanged. However, it is possible that the intervention attenuated, rather than prevented, these changes, but this needs to be confirmed using randomized control trials (McLaughlin et al., 2026).