Abstract P014

Changes in Patient Reported Outcomes and Treatment Tolerance with a Structured Diet and Exercise Plan

Background: Diet and exercise have shown benefits in a variety of cancers but evidence in lymphoma is limited. Here we explore the impact of a structured diet and exercise intervention during treatment on patient-reported outcomes (PRO) in patients (pts) with Hodgkin lymphoma (HL).

Methods: Patients with newly diagnosed lymphoma receiving six cycles of chemotherapy were enrolled on the Lifestyle Intervention of Food and Exercise for Lymphoma Survivors (LIFE-L) trial (NCT05839210) and randomized 2:1 to the intervention arm, where pts followed a Mediterranean diet and a home-based exercise regimen with weekly remote health coaching from a registered dietitian and exercise physiologist, or the control arm. Patient-Generated Subjective Global Assessment (PG-SGA) for malnutrition assessment, handgrip strength, and PRO-Common Terminology Criteria for Adverse Events (PRO-CTCAE) were completed at baseline, before cycle (C) 3 and C6, and 4 weeks post treatment. This is a secondary analysis of HL pts from LIFE-L. Descriptive statistics were used to summarize pt characteristics and generalized linear mixed-effects models evaluated changes in outcomes.

Results: 32 pts with HL were enrolled between 04/26/2023-10/2/2025. Pts were white (91%), Hispanic (84%), and had advanced stage HL (75%) with equal distribution of sex (male 50%). Groups were well balanced other than age; control group (n=13) was younger than intervention group (n=19), 39.8 (SD: 14.0) vs 43.1 (SD: 16.4) yrs old respectively (p<0.001). PG-SGA was significantly different over time (p<0.001) with a trend towards significance between groups (p=0.056), with the intervention arm reporting better nutritional status at baseline. Peripheral neuropathy differed between groups, timepoints, and their interaction (all p<0.001), however, estimates were unstable with large odds ratios, suggesting model instability due to sparse data. Constipation severity varied over time (p=0.001), but not between groups (p=0.771). Fatigue frequency worsened over time (p=0.013), particularly from baseline to C3, (OR 3.41, CI 95%, 1.10-10.56), as did depression severity (p=0.036). No significant difference was observed for vomiting, anxiety, depression, cognition, insomnia or handgrip strength.

Conclusion: The LIFE-L study is among the first interventional trials evaluating a structured diet and exercise program in HL. These early results from this ongoing trial are promising and should be replicated in a more robust sample size.