ENERGIA: Personalized Exercise Program for Fatigue in Patients With Myeloproliferative Neoplasms and Chronic Myeloid Leukemia (ENERGIA)

April 1, 2026 updated by: Carmen Fava

ENERGIA: Exercise in Rare Hematologic Diseases With Individualized and Adapted Management

This study evaluates whether a personalized, supervised exercise program can improve fatigue and physical function in patients with myeloproliferative neoplasms (MPN) and chronic myeloid leukemia (CML). Although many patients achieve good disease control with modern therapies, they often experience persistent symptoms such as fatigue that significantly affect daily life.

Participants will take part in a 12-week exercise program that includes aerobic and resistance training, tailored to their individual fitness level and clinical condition. The program consists of two supervised sessions per week, along with additional home-based aerobic activity. Before and after the program, participants will undergo comprehensive assessments, including cardiopulmonary exercise testing, physical function tests, questionnaires on fatigue and quality of life, and blood sample collection.

The study aims to determine whether this type of exercise program is feasible and safe, and whether it can reduce fatigue and improve physical capacity, quality of life, and biological markers related to inflammation and metabolism. Participants will also be followed after the intervention to evaluate whether the benefits are maintained over time.

Study Overview

Detailed Description

Myeloproliferative neoplasms (MPN), including polycythemia vera, essential thrombocythemia, and primary myelofibrosis, as well as chronic myeloid leukemia (CML), are chronic hematologic conditions characterized by prolonged survival but a substantial and persistent symptom burden. Among these, fatigue represents one of the most prevalent and disabling symptoms, often persisting despite optimal disease control. Its pathophysiology is multifactorial and involves chronic low-grade inflammation, immune dysregulation, neuroendocrine alterations, impaired mitochondrial function, and reduced physical capacity.

Exercise has emerged as a promising non-pharmacological intervention capable of targeting several of these mechanisms simultaneously. Acute and chronic exercise are known to modulate inflammatory pathways, improve mitochondrial efficiency, enhance autonomic regulation, and increase cardiorespiratory fitness and muscle strength. These adaptations are biologically plausible mediators of improvements in fatigue and overall functional status. However, evidence specifically addressing patients with MPN and CML remains limited, and data on feasibility, safety, and mechanistic responses are still scarce.

This study is a prospective, single-arm, interventional trial designed to evaluate the feasibility, safety, and preliminary efficacy of a structured, personalized exercise program in patients with MPN and CML. The intervention consists of a 12-week supervised program combining aerobic and resistance training, delivered twice weekly, with additional home-based aerobic activity to achieve recommended weekly exercise volumes. Exercise intensity is individualized based on baseline clinical and cardiopulmonary exercise testing parameters.

Participants will undergo a comprehensive multidimensional assessment at baseline (T0), after the intervention (T1), and at follow-up (T2). Outcomes include feasibility measures (adherence and retention), safety (adverse events), and clinical endpoints such as fatigue, fatigability, cardiorespiratory fitness, physical function, body composition, cardiovascular risk profile, and psychosocial well-being. In addition, the study includes exploratory analyses of immunometabolic responses, integrating metabolomic and inflammatory biomarker profiling to investigate potential biological mechanisms underlying clinical changes.

The results of this study are expected to provide clinically relevant data on the implementation of exercise as a supportive therapy in patients with chronic hematologic malignancies and to inform the design of future controlled trials.

Study Type

Interventional

Enrollment (Estimated)

25

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • To
      • Torino, To, Italy
        • AO Ordine Mauriziano di Torino
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

Age ≥18 years Confirmed diagnosis of myeloproliferative neoplasm (polycythemia vera, essential thrombocythemia, low-risk primary myelofibrosis) or chronic myeloid leukemia according to WHO criteria Clinical and therapeutic stability for at least 8 weeks prior to enrollment Presence of clinically relevant fatigue as assessed by validated disease-specific questionnaires General clinical condition compatible with participation in a supervised exercise program of at least moderate intensity Absence of contraindications to cardiopulmonary exercise testing No participation in structured exercise or rehabilitation programs within the previous 3 months Minimum hematological safety parameters (hemoglobin >10 g/dL; platelets >100,000 × 10⁹/L) Ability to understand and comply with study procedures Provision of written informed consent

Exclusion Criteria:

Unstable cardiovascular conditions (including uncontrolled heart failure, recent myocardial ischemia, symptomatic ventricular arrhythmias, or unexplained syncope) Thrombotic or hemorrhagic events within the previous 3 months Active acute or chronic infections Severe orthopedic or neurological conditions limiting the ability to perform exercise or functional testing Severe systemic diseases (e.g., advanced renal or hepatic failure, active secondary malignancy, uncontrolled psychiatric disorders) Any clinical condition that, in the investigator's judgment, may compromise safety or adherence to the protocol Indication for a primary structured rehabilitation program based on physiatric evaluation

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Exercise arm
Participants will take part in a 12-week exercise program that includes aerobic and resistance training, tailored to their individual fitness level and clinical condition. Before and after the program, participants will undergo comprehensive assessments, including cardiopulmonary exercise testing, physical function tests, questionnaires on fatigue and quality of life, and blood sample collection.
The intervention consists of a 12-week supervised program combining aerobic and resistance training, delivered twice weekly, with additional home-based aerobic activity to achieve recommended weekly exercise volumes. Exercise intensity is individualized based on baseline clinical and cardiopulmonary exercise testing parameters

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Feasibility: Adherence to Exercise Program
Time Frame: Baseline to 12 weeks
Percentage of completed supervised exercise sessions relative to the total prescribed sessions over the intervention period.
Baseline to 12 weeks
Feasibility: Retention Rate
Time Frame: Baseline to 12 weeks
Proportion of participants who complete the 12-week intervention and post-intervention assessment.
Baseline to 12 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Safety and Tolerability
Time Frame: Baseline to 12 weeks
Incidence and type of adverse events related to exercise, including musculoskeletal injuries, cardiovascular events, and clinical complications temporally associated with the intervention.
Baseline to 12 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Carmen Fava, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

August 1, 2026

Primary Completion (Estimated)

September 1, 2027

Study Completion (Estimated)

December 31, 2027

Study Registration Dates

First Submitted

April 1, 2026

First Submitted That Met QC Criteria

April 1, 2026

First Posted (Actual)

April 9, 2026

Study Record Updates

Last Update Posted (Actual)

April 9, 2026

Last Update Submitted That Met QC Criteria

April 1, 2026

Last Verified

April 1, 2026

More Information

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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