Hemoglobin and Aerobic Fitness Changes with Supervised Exercise Training in Breast Cancer Patients Receiving Chemotherapy

Background: Aerobic exercise training (AET) is known to increase RBC production; however, this has not been evaluated in breast cancer patients undergoing adjuvant chemotherapy. The purpose of this study was to examine the changes in hemoglobin (Hb) levels in the Supervised Trial of Aerobic versus Resistance Training (START) and to determine its association with changes in VO2peak. Methods: Two hundred and forty-two breast cancer patients initiating chemotherapy were randomized to usual care (n = 82), resistance exercise (RET, n = 82), or AET (n = 78) groups for the duration of their chemotherapy (median, 17 weeks). Supervised exercise was thrice weekly based on standard AET and RET prescriptions. Aerobic fitness (VO2peak) and Hb concentration were measured at baseline and end of chemotherapy. Results: Regardless of the exercise group, Hb declined over the course of chemotherapy (13.4 +/- 10.0 to 11.8 +/- 11.5 g/dL, P < 0.01). Both AET and RET groups had significant, moderate correlations between the change in VO2peak and Hb (AET: r = 0.49, P < 0.001; RET: r = 0.39, P = 0.001). Conclusion: The results indicate that regular exercise does not protect against the decline in Hb associated with chemotherapy in breast cancer patients, but resulted in a stronger association between Hb and VO2peak. Impact: Even with the chemotherapy-induced decline in Hb, breast cancer patients can maintain their aerobic capacity by participating in regular aerobic exercise. Further studies are required to determine safe intensity levels that may stimulate the maintenance of Hb levels in breast cancer patients. Cancer Epidemiol Biomarkers Prev; 19(11); 2826-32. (C)2010 AACR.