High-Intensity Interval Training Boosts Immune Cells in Advanced Cancer Patients and Healthy Controls: Implications for Cancer Care

Abstract

Background: Regular exercise improves quality of life (QoL) and reduces fatigue in advanced cancer patients (ACP), but acute immune responses are underexplored. This study investigated the effects of a single high-intensity interval training (HIIT) session on natural killer (NK) cells and circulating innate lymphoid cells (cILCs) in ACP. Methods: An ACP group undergoing chemotherapy (PG, n = 20, 59.8 ± 10.3 years, 70% pancreatic cancer) was compared with age-matched healthy controls (HG, n = 19, 60.7 ± 10.6 years). Both groups completed a 20-min HIIT session. Blood samples were collected before (T0), immediately after (T1), and 1 h post-exercise (T2). NK cells, cILCs, and subsets were analyzed via flow cytometry. Patient-reported outcomes (QoL, fatigue, nutrition) were assessed with validated questionnaires. Results: A single HIIT session induced a significant (PG: p = 0.001; HG: p = 0.045) increase in the number of circulating total NK cells immediately after exercise in both groups, with a median within-subject increase of 50% in the PG and 38% in the HG, followed by a significant (PG/HG: p < 0.001) decrease during the recovery period (PG: –43%, HG: −69%). cILCs increased significantly (PG: p = 0.005; HG: p = 0.001) only during the exercise period in both groups, with a median within-subject increase of 21% in the PG and 55% in the HG. Differences were observed between groups and across individual immune cell subpopulations. NK responses positively correlated with higher training heart rate in both groups, and additionally with BMI (HG, cILC2) and age (PG, CD56brightNK cells). Conclusion: A single HIIT session transiently mobilized NK cells and cILCs in ACP undergoing chemotherapy. These results indicate that acute HIIT is feasible in this population and provide hypothesis-generating evidence on exercise-induced changes in immune cell counts. Trial Registration: The study was registered at 13.11.2022, registration number NCT05656651.