Effects of a Low Versus Moderate–High Intense Exercise Program on Innate Immune Recovery, Fitness, and Quality of Life During Pediatric Allo‐HSCT—The ANIMAL Exploratory Randomized Controlled Trial
Bibliographic record
Abstract
ABSTRACT Objectives Pediatric cancer patients undergoing allogeneic hematopoietic stem cell transplantation (allo‐HSCT) are severely immunosuppressed leading to a high risk for life‐threatening infections. This trial investigates the effects of exercise during allo‐HSCT on immune cell recovery and patient‐related outcomes (DRKS00019865). Methods Twenty‐two pediatric cancer patients (≥4 years) undergoing allo‐HSCT were randomized into an intervention group with moderate to high intensity training (IGhigh) and an intervention group with low intensity training (IGlow). Supervised and individualized exercise sessions were scheduled three to five times per week during hospitalization. The primary outcome was the quantity of NK cells 30 days after HSCT. Further, feasibility and safety of the intervention, physical fitness, fatigue, quality of life (QoL), transplant‐related metrics, and clinical data were assessed. Results At Day +30, the median NK cell count was more than twice as high in the IGhigh compared to the IGlow (n.s., 208.45/µL vs. 99.12/µL). Subset analysis revealed that CD16+ CD56dim NK cells and NKp44+ CD56dim NK cells were higher in the IGhigh on Day +30 (p = 0.043 and p = 0.061, respectively). In contrast, the IGlow exhibited higher levels of NKp44− circulating innate lymphoid cells (cILC3) on Day +15 (p = 0.045). As expected, the IGhigh showed significant increases in leg strength compared to the IGlow. All participants experienced a decline in QoL and fatigue. Conclusion This pilot study implied a trend toward improved immune recovery with moderate to vigorous exercise. Importantly, both programs were safe and feasible. The higher intensity intervention showed significant benefits on leg strength and specific innate immune cell populations, but these findings must be considered preliminary in the context of the exploratory nature of the study.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".