Interrupting sedentary time to improve cardiometabolic health and toxicity in patients with lymphoma receiving chemotherapy: The iSTAND trial.

Abstract

TPS12173 Background: Among lymphoma patients treated with steroids, hyperglycemia is a common side effect. Episodes of hyperglycemia increase the likelihood of chemotherapy alterations, infection risk, and decreased overall survival. Interrupting sedentary time (IST) helps manage glycemic control in the diabetic population but is understudied among lymphoma patients. Additionally, there is preliminary evidence that IST during a chemotherapy infusion may reduce chemotherapy-related adverse effects. Therefore, we designed the iSTAND study to assess the feasibility of a 12-week IST intervention at home and during chemotherapy infusion appointments, and the preliminary efficacy on said intervention on a) cardiometabolic biomarkers and b) chemotherapy completion and toxicities among lymphoma patients. Methods: The iSTAND study is a prospective study aiming to recruit 24 patients diagnosed with lymphoma receiving either R-CHOP or POLA-R-CHP chemotherapy regimens. The first 3 enrolled patients will automatically be assigned to the intervention group to pilot the intervention (pre-pilot group). The remaining 21 patients will be randomly assigned IST intervention (n = 14) or control (n = 7). Five patients have been enrolled thus far (January 2026). The 12-week intervention will include a supervised component completed during chemotherapy infusion appointments and a self-directed home-based component. The in-clinic component will involve 2-minutes of walking every 30-minutes at 65-70% age predicted heart rate maximum, and two lower body resistance exercises every hour (1 set, 5-12 repetitions, 6-7 RPE) repeated for up to 4 hours of the infusion appointment. The home-based component will involve walking 250 steps per hour and alternating two lower and two upper body resistance exercises every hour (6 days/week for 6-12 hours/day). Patients will receive a Fitbit and resistance bands. Additionally, patients will receive daily movement prompts via Fitbit and text messages to encourage and assess adherence. Outcomes will be assessed at baseline prior to the second infusion and post-intervention after the 12-week intervention period. The primary outcome will be feasibility assessed via completion of ≥70% of prescribed activities, ≤50% rate of refusal, ≥70% retention rate, and ≥70% acceptance rate via acceptability of intervention questionnaire. Secondary outcomes include glucose levels and insulin assessed via continuous glucose monitor and fasting blood. Exploratory outcomes include quality of life, sleep quality, chemotherapy completion rate, and chemotoxicities assessed via questionnaires and medical records. Clinical trial information: NCT06923397 .