Feasibility of High Intensity Interval Training in Survivors of Childhood, Adolescent, and Young Adult Hodgkin Lymphoma

Hodgkin lymphoma survivors face elevated risks of cardiovascular disease and premature aging. HIIT, which alternates high-intensity effort with recovery periods, has shown benefits in adult cancer survivors but has not been tested in younger populations. This study will assess whether recently treated survivors can complete a remotely supervised 12-week HIIT program and evaluate its effects on multiple health outcomes. Participants will undergo baseline and post-intervention assessments including exercise testing, body composition, autonomic function, and blood biomarkers. The intervention is delivered via a secure web-based platform with live supervision by exercise physiologists.

• High Intensity Interval Training (HIIT) (Behavioral): Participants will complete a 12-week HIIT program with three 25-minute sessions per week. Each session includes warm-up, five cycles of high-intensity intervals (80-95% peak HR) and recovery periods (50-60% peak HR), and cool-down.

Primary outcomes

• Participation rate (percent of eligible participants approached who enroll) [Trial completion (12 weeks)]: Descriptive statistics will be reported
• Completion rate (percentage of scheduled HIIT sessions attended and percentage of post-intervention testing sessions completed) [Trial completion (12 weeks)]: Descriptive statistics will be reported

Other outcomes

• Cardiorespiratory fitness (VO2peak, ml/kg/min) [baseline at study entry, 12 weeks]: Descriptive statistics of the change between baseline and 12 weeks will be reported
• Ewing battery score of autonomic function (0 to 5 points) [baseline at study entry, 12 weeks]: Descriptive statistics of the change between baseline and 12 weeks will be reported
• Body mass index (weight and height will be combined to report body mass index in kg/m2) [baseline at study entry, 12 weeks]: Descriptive statistics of the change between baseline and 12 weeks will be reported
• Percent body fat (%) [baseline at study entry, 12 weeks]: Descriptive statistics of the change between baseline and 12 weeks will be reported
• Lean mass percentage (%) [baseline at study entry, 12 weeks]: Descriptive statistics of the change between baseline and 12 weeks will be reported
• Visceral fat level (score) [baseline at study entry, 12 weeks]: Descriptive statistics of the change between baseline and 12 weeks will be reported
• Hand grip strength (kg) [baseline at study entry, 12 weeks]: Descriptive statistics of the change between baseline and 12 weeks will be reported
• Knee extension strength (N/kg) [baseline at study entry, 12 weeks]: Descriptive statistics of the change between baseline and 12 weeks will be reported
• Modified total neuropathy scale (0 to 24 points) [baseline at study entry, 12 weeks]: Descriptive statistics of the change between baseline and 12 weeks will be reported
• DNA methylation [baseline at study entry, 12 weeks]: Descriptive statistics of the change between baseline and 12 weeks will be reported
• Mitochondrial DNA copy number [baseline at study entry, 12 weeks]: Descriptive statistics of the change between baseline and 12 weeks will be reported
• Telomere length (kb) [baseline at study entry, 12 weeks]: Descriptive statistics of the change between baseline and 12 weeks will be reported
• High-sensitivity C-reactive protein (mg/L) [baseline at study entry, 12 weeks]: Descriptive statistics of the change between baseline and 12 weeks will be reported
• Interleukin-6 (pg/mL) [baseline at study entry, 12 weeks]: Descriptive statistics of the change between baseline and 12 weeks will be reported
• Physical activity (kilocalories per week) [baseline at study entry, 12 weeks]: Descriptive statistics of the change between baseline and 12 weeks will be reported

Sex: All, ages: 10 Years to 25 Years

Inclusion Criteria:

* Participant has been diagnosed with Hodgkin lymphoma between the ages of 10 to 25 years.
* Participant is between the ages of >10 and <25 years old the time of enrollment.
* Participant has completed treatment (end of chemotherapy for those not receiving radiation therapy or end of radiation therapy) for Hodgkin lymphoma within 24 months prior to enrollment and recovered from any acute treatment-related adverse events.
* Participant has been medically cleared to participate in physical activity.
* Participant verbalizes understanding of directions for use of the web-based platform on the study provided iPad and heart rate monitor.

Exclusion Criteria:

* Participant has evidence of relapsed disease.
* Participant has a diagnosis of acute heart failure.
* Participant reports currently participating in HIIT training or >420 minutes per week of moderate to vigorous physical activity.
* Female participant who is currently pregnant.

• Amy Berkman, MD, Principal investigator, St. Jude Children's Research Hospital