Chronic
Lymphocytic
Leukaemia
News
w w w.l eu ka e m i a.o rg.a u
Caring for
people with
Chronic
Lymphocytic
Leukaemia and
their families
A p r i l 2 011
CARMEL LOVES HER NEW LEASE ON
FARM LIFE
Carmel Bainbridge made some radical
changes to her life after treatment for
breast cancer more than 20 years ago.
To get closer to the “natural side of things”
she moved from living in a Perth beachside
suburb, to the outskirts of the city, after finding
a beautiful 12-acre property.
Her idyllic rural lifestyle on Mimsbrook Farm,
was adversely affected at the beginning
of 2010 by her diagnosis with chronic
lymphocytic leukaemia (CLL).
When Carmel first moved to the farm, her
intention was to simply enjoy living there.
However, discovering the property had rich
flood plain soil, and seeking organic food for
her own health and wellbeing, she “started
reading up” on biodynamic farming.
There were already 500 citrus trees on
the property and Carmel started growing
seasonal vegetables. Her little garden got
bigger and bigger and she got full biodynamic
certification. Her son, Steve, who lives in
Perth, helps her to run the farm and the
organic shop they own in the city.
Carmel indulged her love of animals and
has three cows, a minature pony, a couple
of sheep and 120 chickens to keep her
company. As well, her beloved kelpie,
Skipper, is always by her side and rides with
her on the quad bike she bought to help her
get around the property.
Carmel Bainbridge with her companion, Skipper, on Mimsbrook Farm
“They’re purely my pets, but I use the cow manure to fertilise
and they all just live their lives in luxury. They’re wonderful
for me,” said Carmel, 74, who believes in the importance
of “finding something that gives you a lovely feeling in your
heart”.
“All this has been amazingly healing – I feel great every day.”
The house on her property was originally “very ordinary”, so
Carmel undertook renovations and extensions and created bed
and breakfast accommodation so she could share her “little
farm” with guests.
Recalling when she’d been diagnosed with CLL, over the
previous two years it had taken her a long time to get well after
a cold, and she noticed she felt tired and lacked her usual
energy.
“On the farm, there’s always something to knock yourself
with,” said Carmel, and when a wound from a stick wouldn’t
heal, she went to the doctor and that’s when CLL showed up
in a blood test.
She was treated from April to July last year with four doses
of chlorambucil. The first dose included prednisolone but this
was discontinued because Carmel said the drug “scrambled
my brain, making me feel agitated and it was difficult to do the
farm’s bookwork”.
“When first diagnosed, I didn’t know anything about CLL or
what I was in for,” said Carmel.
“I looked on the Net and called the Leukaemia Foundation to
see if I could get a newsletter.
“The lass I spoke to was very helpful. It was heart-warming to
talk to someone about my concerns and she told me about an
information day. Later I got a call to see if I would go.
OFATUMUMAB + FC REGIMEN TRIALLED
A small phase II* trial has evaluated the safety of varying
doses of ofatumumab when it replaces rituximab in the
FCR** regimen for people with previously untreated CLL.
This would create a new regimen, called O-FC**.
FCR is a common treatment regimen for CLL. The O-FC trial
replaced rituximab with ofatumumab, and then compared two
different doses of the drug – 500mg and 1000mg.
The O-FC regimen was administered in six four-week cycles,
and the key result of the randomised trial is the O-FC regimen
can be given safely.
Ofatumumab is a new human monoclonal antibody (for the
CD20 protein – the same protein targeted by rituximab) and has
approval by the US Food and Drug Administration for treating
CLL that is resistant to both fludarabine and alemtuzumab. The
O-FC trial showed ofatumumab was well tolerated, with a similar
toxicity to rituximab. It was also shown to cause similar mild to
moderate reactions as rituximab, mostly with its initial doses.
Rituximab combined with chemotherapy has already improved
outcomes for people with lymphoid diseases and researchers
have questioned whether O-FC may yield better outcomes than
FCR, in a head to head comparison.
The results of this study provide useful phase II data that are
required before embarking on a larger randomised trial for O-FC.
Another combination being considered for a study is
bendamustine plus rituximab, to see how it compares with FCR
and O-FC.
The Leukaemia Foundation’s National Manager, Support
Services, Anthony Steele, said it was great to have new
treatment options in the pipeline that showed promise for
people with CLL.
“They give hope to the thousands of Australians living with the
disease,” he said.
If you are on a clinical trial for your CLL, the Foundation would
love to hear about your personal experience. Would you
recommend that others take part in a clinical trial? To share your
thoughts, contact Anthony Steele: [email protected].
* A phase II trial gathers data on a treatment’s safety. This trial
did not compare the effectiveness of ofatumumab compared to
rituximab
** FCR: fludarabine and cyclophosphamide combined with
rituximab; O-FC: ofatumumab combined with fludarabine and
cyclophosphamide
CARMEL LOVES HER NEW LEASE ON FARM LIFE
“When I said transport was an issue, they had one of their
volunteers come and pick me up. I was treated like royalty and
I met quite a few nice people and had afternoon tea, and then
I was taken home.
“I was blown away with this kindness. It was fantastic. I can’t
speak more highly of the Leukaemia Foundation. I went
through breast cancer without any support and it was very
clinical and frightening.”
Since finishing her CLL treatment last July, Carmel has been
on a cruise to Japan and eastern Asia with her other son, Jeff,
and four of her grandchildren. And earlier this year, Carmel
took Skipper with her when she spent two weeks in Brisbane
staying with Jeff’s family.
“I had a beautiful rest and I’ve come back feeling 100%,”
said Carmel.
Having CLL has made Carmel feel “a bit
vulnerable”.
“It’s a whole new ball game and it
affects how you feel and how you cope.
“I’m just getting my head around how this jolly
leukaemia is affecting me,” she explained.
“I’m having to make some tough decisions and
I’m learning to let go and slow down. I don’t
have a choice, because physically I can’t do
what I was doing.
“Steve is having to do much more on the farm
and now I am out of the picture in so many
ways,” said Carmel, who previously was kept
busy ordering seedlings, overseeing and
helping with the planting and harvesting,
and packing boxes of organic produce for
customers at their shop.
“I realise I have to be cautious now too, and
not put myself in situations where I could have
an accident. Any tiny scratch becomes a major
issue.
“I’m continuing with a healthy lifestyle and
good nutrition, eating lots of fresh vegies and
salads.
“I keep the mindset right and always have
some plan for the next day."
Carmel with some of her pets who enhance her life
PROMISING NEW CLL GENE DISCOVERY
In a significant breakthrough for CLL patients, Australian
research groups believe they have identified a gene
involved in CLL development that could be used one day
as a target for future CLL treatments.
In collaboration with US and Chinese investigators, the
discovery came after nearly a decade of studying biological
samples from families with an inherited predisposition to CLL.
Recent advances in gene mapping and sequencing
technologies enabled the collaborators to look closely for the
first time at key regions of DNA previously identified, to find
variations that cause CLL.
Large-scale analyses were performed on selected DNA samples
from 13 families in which two or more members had been
affected by CLL. Both affected and unaffected individuals were
included in the search for genetic mutations triggering CLL.
The Leukaemia Foundation funded part of the project led by
haematologist and Senior Lecturer in Medicine at the University
of Sydney, Dr Stephen Fuller. Other centres involved in the
project were the Howard Florey Institute and the Walter and
Eliza Hall Institute of Medical Research, in Melbourne, and the
Centre for Cancer Biology, SA Pathology, in Adelaide.
“There were obviously limitations as to how far down we could
focus when scanning three billion base pairs and over 25,000
genes,” said Dr Fuller.
“However, we’re confident we’ve discovered at least one gene
which has a role in causing CLL to develop in one of the large
families involved in the study,” he said.
“It’s a great feeling because this gene looks very promising.
However, we’ve got some work to do to confirm our finding and
see how common the gene is – whether it’s also a factor in
other families.
“If it can be more broadly applied to other families, and even in
sporadically occurring CLL cases, that would be very exciting
because there would be a real possibility of developing new
drugs to specifically target the gene.”
Dr Fuller estimated it would take at least another 10 years to
fully understand the role of the candidate genes discovered in
their research, and to identify molecules to target the genes as
potential new drug treatments.
Dr Stephen Fuller: “This gene looks very promising”
He plans to continue with the research until it has a treatment
application for patients.
“As a haematologist, I see patients with CLL and other types of
leukaemias every day, so exciting breakthroughs such as this
one give me great hope that my research will make a difference.
“I really am indebted to our patients, the Leukaemia Foundation
and other funding groups, and everyone who’s helped out on
this project over the years.
“We’re now in the process of trying to secure longer term
funding to continue our research, but it is hard to get because
our findings are still at an early stage, and the government
funding bodies usually want to see an immediate return for
their investment.”
The Leukaemia Foundation would like to extend its gratitude
to the late Mr James Selim for providing $100,000 to fund a
one-year Grant-in-Aid in 2010 for this research project.
Families with a history of inherited CLL and/or other blood
cancers, that are not already included in the databases of the
Australian Familial Haematological Cancer Study, are invited to
contact Dr Fuller ([email protected]) or research
nurse Kerry Phillips ([email protected]) to
register to be involved in CLL research.
RITUXIMAB RECOMMENDED FOR PBS LISTING
Rituximab has been recommended for listing on the
Pharmaceutical Benefits Scheme (PBS) for people
with CLL, in combination with fludarabine and
cyclophosphabide.
The Pharmaceutical Benefits Advisory Committee made this
recommendation at its November 2010 meeting. The PBS
listing date has yet to be announced.
The decision follows Therapeutic Goods Administration
approval of rituximab (MabThera®) in January 2010, for
treatment of patients with CD20 positive CLL in combination
with chemotherapy.
This approval is based on compelling results from the pivotal
international phase III CLL8 study by the German CLL Study
Group and Professor Michael Hallek of the University Hospital
Cologne, Germany. The study demonstrated that patients
treated with rituximab lived longer without their disease
progressing, reducing the number of frequent hospital visits.
The study was conducted at 191 study sites across 11
countries and included 817 CLL patients receiving first-line
treatment. In the randomised study, patients received either
rituximab in combination with chemotherapy (fludarabine and
cyclophosphamide) or chemotherapy alone.
The results showed patients who received rituximab in
combination with chemotherapy (FCR) as first-line treatment
lived an average of eight months longer without their cancer
progressing than patients who received chemotherapy (FC)
alone.
“Data from the CLL8 trial suggests that rituximab used in
combination with chemotherapy has the potential to become the
standard of care for the treatment of CLL,” said Professor Hallek.
IMMUNE SYSTEM THERAPIES PROMISING
New therapies that stimulate the immune system may be
beneficial in treating in treating CLL.
The Leukaemia Foundation has funded Associate Professor
David Ritchie and Dr Paul Neeson – who co-head the
Haematology Immunology Translational Research Laboratory
at Melbourne's Peter MacCallum Cancer Centre – to investigate
new treatments to activate CLL cells* and the immune system.
While it may seem unusual to promote cancerous cell activity,
the researchers have compelling preliminary data that immune
stimulating substances can modify CLL cells to activate, which
then stimulates an anti-cancer immune response. Known as
adoptive immunotherapy, in theory it could be possible to use
the treatments in combination with chemotherapy to trigger a
patient’s immune system to eradicate all CLL cells.
Dr Neeson and Associate Professor Ritchie and their research team
Associate Professor Ritchie and Dr Neeson are looking at an
antibody to activate CLL B-cells in combination with alphagalactosylceraminde and the drug, lenalidomide (or Revlimid®)
to stimulate the immune system’s natural killer T-cells. According
to Associate Professor Ritchie, while the three reagents are
being trialled or used for treating human cancer, they have yet to
be applied to CLL.
The laboratory is also developing a new ‘humanised’ model
of CLL with funding from the Leukaemia Foundation. The
pre-clinical model will be used for assessing potential CLL
treatments for humans. A breakthrough in itself, creating the
model will be critical to their latest research project. Until now,
testing new CLL drugs in the laboratory has been limited,
according to Dr Neeson.
“The pharmaceutical companies have been wary about
using some of these therapies to treat CLL in case they over
stimulated the CLL B-cells. However, we have good evidence
that this won’t happen. Our research indicates they will stimulate
the immune system to fight CLL B-cells,” he said.
“When new drugs have been tested in clinical trials, the results
have often been disappointing, and we believe that this poor
result has been due to a lack of good CLL models to test new
drugs,” he said.
“If our research turns out the way we think it will, it will be a
reassuring step for trialling these reagents in humans. No one
has taken these steps yet but we felt this was something that
needed to be looked into further.
“And we’re certainly on the right track, with our collaborators
from the Malaghan Institute of Medical Research winning the
‘Best Research Award’ at the 2010 Haematology Society of
Australian and New Zealand for their preliminary work in treating
CLL cells with alpha-galactosylceraminde,” said Associate
Professor Ritchie.
Through collaborations with pharmaceutical companies,
Associate Professor Ritchie and Dr Neeson have assembled
human-approved, clinical-grade reagents to undertake their
research into CLL. Theirs is the only Australian laboratory with
this unique set of clinically relevant reagents, along with a stored
source of CLL samples. If their results prove promising, they will
be able to move straight into clinical trials.
A new model which simulates the CLL micro-environment in
humans will greatly help researchers identify how to target the
disease more effectively.
“This will ensure better testing of new drugs prior to clinical trials
and a higher success rate. We’ve completed the preliminary work
and are now moving on to growing patient cells,” said Dr Neeson.
Associate Professor Ritchie said the model would help ensure
the direct translation of their CLL research into the clinic.
“We needed this humanised model to ascertain that the
reagents we’re testing can be used safely, that human CLL
B-cells won’t go crazy, and that the human immune system will
be stimulated to fight the CLL cells,” he said.
The CLL project is central to the Haematology Immunology
Translational Research Laboratory, which is focused on using
patients’ own cells to fight their cancer.
* CLL cells are cancerous B lymphocytes, or B-cells, a form of white
blood cell
POTENTIAL NEW TREATMENT FOR CLL - GA101
The development of a potential new therapy, GA101, shows
great promise for people with CLL.
GA101 is a new monoclonal antibody that targets the CD20
antigen on B-lymphocytes.
Although CD20-targeted therapy with rituximab has greatly
enhanced outcomes for patients with CD20 positive CLL,
resistance to rituximab can be a major problem.
A better understanding of rituximab resistance has led to the
development of new, improved second-generation anti-CD20
antibodies, including GA101.
Early trials suggest that the GA101 therapy works more
effectively than rituximab in targeting B-CLL cells.
In an initial phase I trial, patients with relapsed or refractory
(resistant to rituximab) CD20 who had no alternative treatment
options, were treated with the GA101 antibody. Since the trial
began in January 2008, 22 patients in Canada, aged between
47 and 77 years, have been treated with GA101 at doses
varying from 100mg to 2000mg.
The drug was well tolerated and considered safe at all dose
levels trialled, and is currently in phase I/II clinical trials to test
how effective it is in treating CLL.
An international trial by the German CLL study group is now
comparing the effectiveness of GA101 compared to other
currently available treatment regimens.
At present, GA101 is not registered for use in Australia by the
Therapeutic Goods Administration.
THE ‘WATCH AND WAIT’ CHALLENGE
One of the most challenging aspects of being diagnosed
with CLL is the statement ‘watch and wait’, says facilitator
of the Leukaemia Foundation’s national CLL telephone
forums, Cathy Paine.
“This is the one overwhelming thing that has jumped out at me
over the last year as I’ve talked to peopIe with CLL,” said Cathy,
a support services co-ordinator.
“When first diagnosed with CLL, most people will be told they
need to ‘watch and wait’ or, more to the point, ‘watch, wait and
worry’.
“To be told you have leukaemia is devastating and frightening.
“To be told “we are going to do nothing about it and just watch it
at the moment” is an enormous psychological challenge,” Cathy
explained.
“On the other hand, nobody is keen to move on to treatments
like chemotherapy unless absolutely necessary, especially
as almost a third of all people diagnosed with CLL will never
actually require treatment. It’s quite a conundrum.
“While ‘watch and wait’ is a valid approach for CLL, many
people find it hard to sit by and do nothing, which can leave
them feeling extremely powerless.”
As a consequence, Cathy said many people find they regain
some feeling of control over their situation by setting out to
change their lifestyle, or their diet, or both.
By taking a proactive approach to having a healthy body,
focusing on nutrition, complementary therapies, stress
management and exercise, they feel they may be able to
prolong the ‘watch and wait’ period, with the goal of never
having to move on to chemotherapy-type treatment.
Some seek advice outside the area of conventional medicine.
This may include searching the internet, which Cathy said can
be a minefield of conflicting information.
“Forums such as our regular
CLL telephone forum can help
people to feel less isolated
and assist in giving them back
a sense of control,” she said.
“We often have guest
speakers on the forum,
such as nutritionists and
haematologists who are
experts in their field, so good
and current information is
easily accessible.
“Discussing concerns, tips
and advice on the forum with
these experts, as well as
with other participants who
have CLL, can also alleviate
some feelings of isolation or
powerlessness,” Cathy said.
“The most important message
is for patients to receive good
Facilitator, Cathy Paine
advice from credible sources
who recognise that the treatment of CLL is highly individual, as
is the response to any medication, ‘natural’ or otherwise.
“It is also critical for everyone with CLL to inform the
haematologist who is providing their medical care, about
what they are doing that may help keep their disease at bay –
including any natural therapies.”
To participate in the national CLL telephone forum,
please contact Cathy Paine on 02 6663 1288 or email:
[email protected].
You may also like to access the Leukaemia Foundation’s online
discussion forum: www.talkbloodcancer.com.
AUSTRALIAN RESEARCHERS DISCOVER NEW
CELLULAR PROTEINS THAT MAY PROMOTE CLL
An Australian research
team has discovered
two proteins that
appear to play a role in
in CLL cells surviving.
surviving chemotherapy
treatment.
Associate Professor Devinder Gill
Based at the Princess
Alexandra Hospital
and The University of
Queensland Diamantina
Institute in Brisbane,
Associate Professor
Devinder Gill and
Associate Professor Nigel
McMillan led a study into
two new cell survival
proteins they identified in
CLL cells.
The pair was awarded a
2010 Leukaemia Foundation Grant-in-Aid funded by Roche
Products Pty Ltd to undertake the research.
They found the proteins were elevated in CLL patients’ blood,
while also accumulating vital information about the leukaemia
micro-environment (the normal cells and tissues that the
leukaemia lives with) and how it promotes CLL cell survival.
According to Associate Professor Gill, their results supported
the notion that these proteins may play a role in CLL disease
progression.
“We showed that these newly discovered proteins
are produced by healthy cells in the leukaemia microenvironment, and that CLL cells have the ability to respond
to these survival signals, allowing them to evade potent
chemotherapy treatments,” said Associate Professor Gill.
“Our results will definitely help expand the current
understanding of the proteins involved in CLL cell survival.
“And we’ve confirmed a potential biological role for these
proteins in CLL, perhaps providing a target for a new CLL
treatment to be developed,” he said.
Associate Professor Gill extended his gratitude to the
Leukaemia Foundation, Roche Pharmaceutical and the
Australasian Leukaemia & Lymphoma Group Tissue Bank
for their support of the research project.
CLL HASN’T STOPPED PIERS BEING “AS B
Being diagnosed with CLL in 2003 came completely out
of left field for Piers Hartley, and proved to be a double
whammy for the retired school principal.
When Piers had a blood test because he had diabetes in
his family, CLL was picked up along with Type 2 diabetes.
Although Piers, 69, of Mt Beauty, in Victoria’s northeast,
said he had no CLL symptoms, he believes he may have
had the condition for a while.
When he went to see a general physician after his
diagnosis, Piers was told his diabetes was much worse
than his CLL.
“My GP said - ‘I won’t see you again for your CLL for 20
years. If you’re going to get cancer, this is the best one to
get’, so I came home and felt very pleased about that,” he
explained.
“However, his comment was wrong, and this is a common
misconception by some medical practitioners. CLL varies
a lot from one person to another and some cases need
prompt medical treatment.
“Much better diagnostic tests are available today and
anyone now diagnosed with CLL should seek the advice of a
haematologist, preferably one with specialist CLL expertise,”
said Piers.
Piers Hartley and his wife, Margaret
To keep an eye on the CLL after this diagnosis, Piers had a
full blood count every six months with his local doctor, but
gradually his lymphocyte count started to go up. Over three
years, it went from 15% at diagnosis, to 60-70%, and when
Piers started getting swollen lymph glands, he was referred to
a haematologist in 2006.
“He was quite encouraging and said he’d watch and wait and
when it got to a certain level, we’d talk and do something
about it.”
Piers’ levels continued to increase over the next 18 months
and when this rise became more rapid, he started a course of
oral chemotherapy (chlorambucil) for several months.
“It had a modest impact and reduced my lymphocyte count
initially, but didn’t hold it,” said Piers, and when his count
reached 180, in April/May 2009, Piers began a course of
rituximab.
“Again, the treatment had some affect, but didn’t deal with
it,” said Piers, and in September that year, he chose to go
to Melbourne to start a six-month course of the combination
treatment, FCR*.
YOGA IMPROVES SLEEP AND REDUCES FATIGUE
Practicing yoga may improve sleep, reduce fatigue and
boost the overall quality of life for people with CLL.
According to findings of the largest scientific study to examine
the value of yoga specifically designed for cancer survivors,
participants also reported reducing their need for sleep
medication.
“Physicians frequently
have trouble discussing
these approaches with
patients, but this study
applies real science to
the issue,” he said.
“This is a readily applicable approach that improves quality of
life and reduces medicine intake in cancer survivors. This is a
real positive,” said George W. Sledge Jr, MD, president-elect
of ASCO.
The cancer survivors
who participated in the
study were enrolled
in a specialised
program known as
YOCAS (Yoga for
Cancer Survivors) that
includes breathing
exercises, gentle
hatha and restorative
yoga postures, and
mindfulness exercises.
As reported in the journal, Medscape Oncology,
complementary medicine, including yoga, is common among
cancer survivors, particularly women. Dr Sledge pointed out
that this study is “a creative application of scientific technique
to complementary and alternative medicine approaches”.
The classes were
75 minutes long and
participants attended
twice a week for four
weeks.
Once they began a yoga program, participants decreased
their use of sleep medication by 21%, compared with the
control group, who increased their use of sleep medication by
5% during the same time period.
The results of the study were presented at the American
Society of Clinical Oncology (ASCO) 46th Annual Meeting in
Chicago, Illinois last year.
BUSY AS EVER”
“It was brilliant. It just knocked the
lymphocytes right out, and over three
months they went from 180 to zero. It
absolutely did the trick, and quickly.”
“I live in a small rural town and I use the
internet a lot. It’s a wonderful source of
helpful information and there are some
fantastic CLL patient websites.
After the fifth cycle, in January 2010,
Piers stopped the treatment because
he was too sick and his blood counts
were very low.
“I check in every day to see the latest
posts, but you have to be careful and not
take everything as gospel. When I go to
the doctor, I tell him what I’ve read and we
discuss it – it is a most helpful relationship.
“I felt pretty awful, had no energy, was
very tired, and susceptible to infection.”
“A subtle thing about CLL is that it’s not a
physical tumour. It’s not visible and I think
the long-term effect of that hanging over your
head can be quite draining. This is something
family, friends and medical practitioners all
need to be conscious of in providing care and
support for people with CLL.
Over the next four months Piers
was unwell, was hospitalized for
an infection, and developed skin
rashes, which required a course of
prednisolone.
“It fixed my immune system within a few
days and I have been fine since then. In
a short time my blood counts improved,
I got my energy back, and I haven’t had
any problems since.”
Piers is getting on with life
Piers said the Leukaemia Foundation had helped him in
several ways, although he “didn’t get connected with the
Foundation” until well into his CLL journey. **
“When I was in Melbourne, they provided financial assistance
and accommodation close to the hospital.
“I was involved in the Foundation’s review for the update of the
CLL information booklet and I take part in the CLL telephone
forums, which I think are both very good.
“I’ve been on the Foundation’s website a lot and to the Talk
Blood Cancer website forum (www.talkbloodcancer.com)
where I put in my two cents worth, if it’s relevant,” he said.
“I feel that from time to time, but you have
to get on with life and not worry about the
next blood test,” said Piers, who is as busy
as ever.
He started learning the flute, aged 59, has played in the local
community band, and co-ordinates 50 volunteers who provide
disaster recovery in the region, mainly for bushfires.
“Having an accurate diagnosis, an approachable specialist
and knowledge about the most appropriate treatments have
all helped me have a sense of control over this disease, and
allowed me to truly get on with my life.”
* fludarabine (F), cyclophosphamide (C) and rituximab (R)
** Many people with CLL do not need treatment when
diagnosed and often they are not referred to the Leukaemia
Foundation as there is a perception that they don’t need the
same support as those who are treated immediately.
Study proves benefits of exercise
A study shows exercise has the potential to relieve
fatigue, which is the most commonly reported side-effect
of CLL.
Patients who exercised during cancer treatment experienced
less fatigue, more vigour and less emotional distress than
those who were less active, according to a randomized trial.
Of the 138 who participated in the trial, 73 were randomised
to the exercise group and 65 to the usual-activity group. The
patients were newly diagnosed with prostate or breast cancer
and had no other health problems or disabilities that limited
their ability to participate.
They weren’t exercising more than three times or 120 minutes
per week when they enrolled in the study. The mean age of
the participants was 60 years and they were to be treated with
chemotherapy and/or radiation therapy.
Each participant in the exercise group received an individual
exercise prescription based on their physical condition. They
were to walk briskly for 10 minutes, increasing to 30 minutes,
five days a week. The walking intensity was designed to reach
approximately 50% to 70% of maximum heart rate.
A total of 93% of patients in the exercise group and 89% of
patients in the usual-activity group completed the study.
Increased aerobic exercise was significantly associated with
less fatigue and those who exercised throughout the study
period had 7.5% more vigour and 3% less emotional distress
compared with those who were less active.
A flexible, home-based exercise program has few risks and
potential benefits for cancer patients, regardless of diagnosis,
according to Dr Jennifer Wenzel who presented the findings at
the 16th International Conference on Cancer Nursing.
“Future intervention studies among patients receiving active
cancer treatment should evaluate exercise guidelines specific
to age or treatment type and, possibly, to cancer diagnosis,”
said Dr Wenzel, assistant professor at Johns Hopkins School
of Nursing in Baltimore, Maryland.
“Exercise interventions are receiving increasing attention
and have been shown to have some benefit,” said Mary Lou
Siefert, DNSc, assistant professor at the William F. Connell
School of Nursing at Boston College in Massachusetts.
“I would continue to suggest to my patients that short amounts
of exercise, such as walking, are helpful.”
The Leukaemia Foundation offers education programs on
the benefits of exercise. To find out when and where these
are held, call 1800 620 420 or visit www.leukaemia.org.au
(Services > Education & support programs).
EDUCATION AND SUPPORT PROGRAMS
NEW SOUTH WALES
VICTORIA
5 Apr
7 Apr
7 Apr
12 Apr
14 Apr
Tuesday Chat, Your Options in Aged Care, Coffs Harbour
(also 10 May, 14 Jun)
19 May
1011.30am
1011.30am
10.30am12noon
10.30am12noon
10am12noon
6-8pm
Patient Education Morning Tea, Alstonville
26 May
6-8pm
South Coast Haematology Information and Support Group,
Moruya (also 9 Jun)
Stress Management/Relaxation, San Remo
5 Apr
1011.30am
11am
Patient and Carers’ Coffee Morning, Shortland Wetlands
(also 3 May, 7 Jun)
Tuesday Chat, Port Macquarie
10.30am12noon
11am1pm
Patient Morning Tea, Rural Cancer Care, Orange
10:30am12noon
10:30am12noon
10am12noon
1-3pm
2-3:30pm
Young Haematology Information and Support Group, Young
(also 2 Jun)
Patient Morning Tea, Palliative Care, Bathurst (also 27 Apr)
8 Apr
13 Apr
19 Apr
28 Apr
11am1pm
11am1pm
1011.30am
Stress Management/Relaxation, Erina Fair
3 May
10am11.30am
Patient and Carers' Morning Tea, Interpreting Blood Results,
Leukaemia Foundation Hunter office, Newcastle
5 May
10.30am12noon
Patient Morning Tea, Dietician, Orange
10 May
10.30am12noon
Tuesday Chat, Patient and Carers’ Morning Tea, Coffs
Harbour
Patient Morning Tea, Bathurst
12 May
2-3.30pm
5.307.30pm
Laughter Therapy, San Remo
South Coast Haematology Information and Support Group,
Bega
25 May
TBA
10.30am12noon
Wednesday Chat, Tamworth
Patient Morning Tea, Dietician, Dubbo
16 Jun
26 May
1011.30am
Laughter Therapy, Erina Fair
18 Apr
1.30-3pm
31 May
TBA
Tuesday Chat, Taree
28 Apr
11am
TBA
TBA
NSW Patient Conference, Sydney
9 Jun
10-11am
Coffee Morning, Warnervale
1011.30am
Coffee Morning, Erina Fair
South East Melbourne Blood Cancer Information and
Support Forum, Clayton
Shepparton Blood Cancer Information and Support Forum
Horsham Blood Cancer Information and Support Forum
CLL Information and Support Forum, Preston
TASMANIA
28 Apr
30 Jun
Bone Marrow Transplant Information and Support Forum,
Preston
Mornington Peninsula Blood Cancer Information and Support
Forum, Mornington
Leukaemia Foundation Yoga Program, Preston (also 18 May)
19 Apr
Hobart Blood Cancer Taking Control Seminar, The Role of the
Social Worker
Launceston Blood Cancer Information and Support Forum
(also 17 May)
AUSTRALIAN CAPITAL TERRITORY
12 Apr
20 Apr
6 May
20 Apr
10am-12
noon
11am1pm
9.30am3pm
11am1pm
6-8pm
Canberra Haematology Information and Support Group,
Narrabundah (also 10 May, 7 Jun)
Nutrition Seminar and Practical Demonstration, Canberra
Patient and Carers' Day, Relaxation, Dickson Community
Centre, Canberra
Nutrition Seminar and Practical Demonstration, CIT Reid
Campus
Seminar: Stem Cell Transplants, Canberra
WESTERN AUSTRALIA
1 Jun
Patient Support Group, North Perth (also 20 Jun; 18 Jul;
15 Aug; 19 Sep; 17 Oct; 12 Dec)
Lymphoma Education Program: Eating Well, Subiaco
WA Patient Conference, Perth
NORTHERN TERRITORY
1 Apr
1011.30am
Blood Cancer Support Group morning tea, Darwin (also 6
May)
NATIONAL TELEPHONE FORUMS
SOUTH AUSTRALIA
Telephone forums are held regularly for CLL patients in regional
and remote areas, and for metropolitan patients who have
difficulty accessing the Leukaemia Foundation’s regular education
activities. To find out more, and to register, contact your local
support services co-ordinator on 1800 620 420.
14 Apr
10.30am
Southern Metro Coffee Group, Reynella (also 12 May; 9 Jun)
19 Apr
10.30am
North East Metro Coffee Group, Salisbury East (also 17 May;
21 Jun)
29 Apr
10.30am
Strathalbyn Coffee Group (also 19 May; 16 Jun)
To register for all education and support programs, contact:
27 May
10.30am
Carers’ Coffee Group, Royal Adelaide (also 24 Jun)
LEUKAEMIA FOUNDATION SUPPORT SERVICES
PH: 1800 620 420 (FREECALL)
4 Jun
27 Jun
SA Patient Conference, Adelaide
10am
The Queen Elizabeth Hospital Carers’ Coffee Group, Adelaide
For more information: visit www.leukaemia.org.au
(Services > Education & support programs section)
OUR VISION TO CURE AND MISSION TO CARE
The Leukaemia Foundation is the only national not-for-profit organisation
dedicated to the care and cure of patients and families living with
leukaemias, lymphomas, myeloma and related blood disorders.
The Foundation’s free services include emotional support,
accommodation, transportation and practical assistance for patients and
their families. It also funds research into cures and better treatments for
leukaemias, lymphomas, myeloma and related blood disorders.
The Foundation receives no direct ongoing government
funding and relies on the continuous support of
individuals and corporate partners to provide its services
and to fund its research programs.
To find out more about the work of the Leukaemia
Foundation and how we can help you, phone
1800 620 420 or visit www.leukaemia.org.au.
Roche proudly supports the Leukaemia Foundation in its educational activities through an unrestricted education grant.
Disclaimer: No person should rely on the contents of this publication without first obtaining advice from their treating specialist.