A novel mobile health exercise intervention for older patients with myeloid neoplasms

针对老年髓系肿瘤患者的新型移动健康运动干预

• 批准号: 10693908
• 负责人: Kah Poh Loh
• 金额: $ 24.9万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-16 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10693908
• 关键词: Address; Adherence; Adult; Behavior Therapy; Behavioral; Biological Markers; Cancer Control; Cancer Patient; Clinical Trials; Cytokine Gene; Data; Development Plans; Diagnosis; Education; Elderly; Exercise; Fatigue; Feedback; Gene Expression; Genes; Goals; Grant; Home; Individual; Inflammatory; Interleukin-1 beta; Interleukin-6; Interleukin-8; Interruption; Intervention; Intervention Studies; Interview; Malignant Neoplasms; Measures; Mentors; Methylation; Mobile Health Application; Moods; Myeloproliferative disease; Oncologist; Oncology; Outpatients; Pathway interactions; Patient Outcomes Assessments; Patients; Phase; Physical Capacity; Physical Function; Physical Performance; Physical activity; Placebos; Positioning Attribute; Printing; Quality of life; Randomized, Controlled Trials; Research; Research Personnel; Research Priority; Scientist; Self Efficacy; Serum; Solid Neoplasm; Symptoms; TNF gene; TNFR-Fc fusion protein; TNFRSF1A gene; Training; Translational Research; Treatment Efficacy; Universities; Walking; affective disturbance; aged; arm; cancer therapy; career development; chemotherapy; clinical practice; comorbidity; cytokine; design; epigenetic regulation; exercise adherence; exercise intervention; exercise physiologist; exercise prescription; exercise program; experience; improved; intervention effect; mHealth; mobile application; novel; older patient; phase I trial; post intervention; prevent; promoter; protein expression; public health relevance; resistance exercise; skill acquisition; standard of care; symptomatic improvement; usability

PROJECT SUMMARY Overview: Over 60% of myeloid neoplasms (MN) are diagnosed in adults aged ≥60 years, and up to 98% of these patients [including those receiving hypomethylating agents (HMA)] experience physical function decline and symptoms (e.g. fatigue, mood disturbances), leading to poor quality of life (QoL). Exercise may prevent physical function decline and improve symptoms in older patients with MN. Older patients with MN can exercise safely, but adherence may be a challenge. Mobile health (mHealth) application (app) may improve adherence by enhancing exercise self-efficacy and by helping to address barriers to exercise. Inflammatory dysregulation [specifically tumor necrosis factor (TNF)α and related cytokines] is associated with physical function decline, fatigue, and mood disturbances. In this K99/R00, we propose to develop, adapt, and evaluate a novel mHealth exercise intervention for preventing physical function decline, improving symptoms, and preventing worsening QoL in older patients with MN receiving outpatient HMA, and to explore the effect of the intervention on TNFα and related cytokine gene promoter methylation and their gene and protein expression. Career Development Plan: Dr. Loh is an emerging geriatric oncologist and has begun to study mHealth and cancer control. To become an independent clinician scientist conducting mHealth behavioral intervention research for older patients with MN, Dr. Loh needs training to (1) develop and adapt mHealth behavioral interventions for older patients with cancer, (2) acquire skills to become an independent investigator who can design, conduct, and analyze clinical trials, (3) develop expertise in biomarkers of physical function. Dr. Loh's mentoring team has expertise in geriatric and exercise oncology, behavioral intervention research, mHealth, and translational science. The University of Rochester is world-class for geriatric oncology and cancer control. Research Plan: The proposed mHealth exercise intervention (GO-EXCAP Mobile App) integrates the content of an established exercise program (EXCAP) with a mobile app delivery platform (TouchStream). EXCAP is a home-based progressive walking and resistance exercise program. The TouchStream mobile app tracks exercise data, symptoms, and barriers to exercise adherence, and the exercise physiologist can adjust exercise prescriptions and address barriers to exercise. In K99, we will first develop and adapt the GO-EXCAP Mobile App by obtaining feedback from 10 patients with MN receiving HMA. Second, we will conduct a single- arm phase 1 trial to optimize the GO-EXCAP Mobile App in 25 patients. In R00 (phase 2 randomized controlled trial), we will assess the preliminary efficacy of the GO-EXCAP Mobile App versus a chemotherapy education control (behavioral placebo) on physical function and patient-reported outcomes (fatigue, mood, and QoL) in 100 patients. We will also explore the effect of the intervention on TNFα and related cytokine pathways. Impact: The combined training and research plan will position Dr. Loh to become one of the few geriatric oncology investigators studying mHealth interventions, and to allow her to transition to independence.

项目总结

项目成果

Management of Acute Myeloid Leukemia (AML) in Older Patients.

• DOI: 10.1007/s11912-020-00964-1
• 发表时间: 2020-07-28
• 期刊: Current oncology reports
• 影响因子: 4.7
• 作者: Abdallah M;Xie Z;Ready A;Manogna D;Mendler JH;Loh KP
• 通讯作者: Loh KP

Embedding lifestyle interventions into cancer care: has telehealth narrowed the equity gap?

• DOI: 10.1093/jncimonographs/lgac028
• 发表时间: 2023-05-04
• 期刊: Journal of the National Cancer Institute Monographs
• 作者: Dennett, Amy M.;Hirko, Kelly A.;Salerno, Elizabeth A.
• 通讯作者: Salerno, Elizabeth A.

COVID-19 vaccines in older adults with cancer: a Young International Society of Geriatric Oncology perspective.

• DOI: 10.1016/s2666-7568(21)00060-x
• 发表时间: 2021-05
• 期刊: The lancet. Healthy longevity
• 作者: Loh KP;Soto-Perez-de-Celis E;Mislang AR;Chan WL;Battisti NML
• 通讯作者: Battisti NML

Updated International Society of Geriatric Oncology COVID-19 working group recommendations on COVID-19 vaccination among older adults with cancer.

• DOI: 10.1016/j.jgo.2022.07.005
• 发表时间: 2022-09
• 期刊: JOURNAL OF GERIATRIC ONCOLOGY
• 影响因子: 3
• 作者: Soto-Perez-de-Celis, Enrique;Mislang, Anna Rachelle;Gabriela Hernandez-Favela, Celia;Russo, Chiara;Colloca, Giuseppe;Williams, Grant R.;O'Hanlon, Shane;Cooper, Lisa;O'Donovan, Anita;Audisio, Riccardo A.;Cheung, Kwok-Leung;Girones-Sarrio, Regina;Stauder, Reinhard;Jaklitsch, Michael;Cairo, Clarito;Gil, Luiz Antonio, Jr.;Alam, Mahmood;Sattar, Schroder;Kantilal, Kumud;Loh, Kah Poh;Lichtman, Stuart M.;Brain, Etienne;Wildiers, Hans;Kanesvaran, Ravindran;Luca Battisti, Nicolo Matteo
• 通讯作者: Luca Battisti, Nicolo Matteo

Disparity in Utilization of Multiagent Therapy for Acute Promyelocytic Leukemia in the United States.

美国急性早幼粒细胞白血病多药治疗的利用差异。

• DOI: 10.1016/j.clml.2021.10.010
• 发表时间: 2022
• 期刊: Clinical lymphoma, myeloma & leukemia
• 作者: Dhakal,Prajwal;Lyden,Elizabeth;Joshi,Utsav;Pyakuryal,Avantika;Gundabolu,Krishna;Zeidan,AmerM;Loh,KahPoh;Fisher,AlfredL;Bhatt,VijayaRaj
• 通讯作者: Bhatt,VijayaRaj