262 A supervised strength and outpatient exercise regimen in pediatric patients with acute lymphoblastic leukemia (STRONGER ALL)

Objectives/Goals: The objective of this pilot interventional study is to assess feasibility and preliminary efficacy of implementing a supervised, outpatient aerobic, and strength exercise regimen in newly diagnosed children and young adults with ALL. We hypothesize that early implementation of exercise is feasible and may prevent cardiometabolic late effects. Methods/Study Population: We aim to enroll 10–20 children with newly diagnosed ALL between 11 and 21 years old to participate in a 12-month supervised, structured outpatient exercise regimen (STRONGER ALL). This regimen consists of low- to moderate-intensity aerobic and strength exercises (either in person or coached virtually per patient preference) 3 times a week. This study includes 2 physical fitness assessments: 1) baseline and 2) end of study. Assessments include resting energy expenditure, peak oxygen uptake, bone density, upper and lower extremity strength, flexibility, and questionnaires (feasibility and quality of life). Additionally, blood and urine specimens will undergo metabolomic analysis to identify biomarkers predictive of future cardiometabolic outcomes. In the first year, 7/8 eligible patients have enrolled. Results/Anticipated Results: We expect that early implementation of STRONGER ALL in children undergoing chemotherapy will be feasible and preliminarily effective at mitigating risk factors for long-term cardiometabolic outcomes in survivors. Feasibility will be defined by recruitment capability (at least 50% of eligible patients agree to enroll), acceptance/compliance (at least 50% of participants complete the program with participation in at least 50% of sessions), data acquisition (collection and outcomes measures are appropriate), and practicability (program shows promise of being successful with pediatric ALL patients as measured by validated surveys administered to patients and caregivers). We anticipate that ALL patients participating in STRONGER ALL will have improved fitness and quality of life. Discussion/Significance of Impact: We aim to show that exercise during intensive chemotherapy for children with ALL is safe, feasible, and beneficial. Participants train 3x/week for 12 months (in-person or virtual), complete fitness tests, and answer health and quality-of-life surveys to inform future care. This work addresses barriers to implementing exercise in this population.