Exercise Helps Blood Cancer Patients During Treatment, but Diet Evidence Lags

This is a narrative review, not a new trial. The authors, led by Kah Poh Loh, gathered and assessed existing research on exercise and nutrition in leukemia, lymphoma and multiple myeloma. The review does not report a single pooled sample of participants. Because the studies it covers differ in design, patients and outcomes, the authors say they cannot draw definitive conclusions.

The topic matters because people with these cancers are living longer thanks to better treatments. Those treatments often cause toxic effects that lower quality of life. In the United States, an estimated 62,770 people were expected to be diagnosed with leukemia in 2024, along with 89,190 with lymphoma and 35,780 with multiple myeloma, according to figures cited in the paper.

The strongest exercise evidence comes from stem cell transplant. The review points to meta-analyses of randomized trials: one from 2013 with 8 trials, one from 2022 with 25 trials, and one from 2025 with 8 trials. According to the review, these found exercise during transplant is feasible and safe. It improved heart and lung fitness, muscle strength and day-to-day function. Effects on upper-body strength, quality of life and thinking were smaller. The 2025 analysis also found less fatigue.

Timing may matter. The review says exercise before a transplant may bring the biggest gains in function. Exercise after transplant, in hospital or as an outpatient, may mainly slow the decline caused by treatment rather than reverse it. One large trial of minimally supervised exercise before, during and after transplant was linked to lower death rates after hospital discharge.

Outside transplant, the picture is similar but less settled. A 2022 meta-analysis of 15 studies, 11 of them randomized trials, found better walk-test results, higher peak oxygen uptake and better quality of life during treatment. Supervised exercise appeared feasible in acute leukemia, even during intensive chemotherapy. Results varied by disease. In myeloma, a 15-week home program reduced anemia but did not improve fatigue, sleep or aerobic performance. In lymphoma, supervised aerobic exercise improved physical function, fatigue and well-being. The authors say larger trials for each disease are needed.

Nutrition evidence is weaker. Much of it focuses on keeping nutritional status up and cutting complications during transplant. Weight loss during transplant has been linked to higher death rates not caused by relapse and to longer hospital stays. Some randomized trials suggest tube feeding into the gut may lower the risk of graftversus-host disease compared with feeding by vein, without clear effects on survival. Oral glutamine supplements showed no benefit. Practice differs widely between centers, and a recent trial found a relaxed diet was not a safe alternative to a lowbacteria diet in transplant for acute leukemia.

The review also covers risk. Observational studies link more physical activity and plant-based eating patterns to a lower chance of developing some blood cancers. In one pooled cohort of 1.44 million people, high leisure-time activity was linked to lower risk of acute myeloid leukemia and other myeloid neoplasms (hazard ratio 0.80) and of multiple myeloma (0.83). Several meta-analyses, however, found no clear link. These are associations, not proof of cause, and no randomized trial has tested diet or exercise for preventing blood cancer.

Lab work in rodents and microfluidic models hints at ways exercise and diet might affect disease, including immune regulation, inflammation and the gut microbiome. These findings are early and have not been shown to apply to patients.

What to watch next

Disease-specific randomized trials, which the authors say are needed to define safe and effective exercise and nutrition plans.

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