Rehabilitation for Patients with Blood Cancers Confirmed Safe Despite Bleeding and Infection Risks, with No Major Adverse Events such as Falls

Physical Function Improves by 30.8% After More Than 20 Rehabilitation Sessions for Patients with Blood Cancers such as Leukemia and Lymphoma

“Findings to Provide Practical Evidence for Establishing Rehabilitation Fees and Expanding Dedicated Staff for Patients with Blood Cancers”

▲ Professors Jae Yong Jeon and Seungwoo Cha of the Department of Rehabilitation Medicine and Professors Jung-Hee Lee and Joon Young Hur of the Division of Hematology at Asan Medical Center

Cancer patients often experience generalized weakness due to anticancer treatment and repeated hospitalizations. While evidence supporting the benefits of rehabilitation in patients with solid tumors has accumulated and rehabilitation is now provided according to clinical guidelines, concerns have remained about the safety of rehabilitation for patients with blood cancers, who face a higher risk of bleeding and infection due to conditions such as thrombocytopenia and anemia.

A recent study by Korean researchers has found that rehabilitation is safe for patients with blood cancers and that greater improvements in physical function can be achieved with more rehabilitation sessions.

A research team led by Professors Jae Yong Jeon and Seungwoo Cha of the Department of Rehabilitation Medicine and Professors Jung-Hee Lee and Joon Young Hur of the Division of Hematology at Asan Medical Center recently reported that an analysis of physical function before and after rehabilitation in patients with blood cancers showed significant improvements following rehabilitation. In particular, patients who received more than 20 rehabilitation sessions showed an approximately 30.8% improvement in physical function.

Blood cancers are diseases in which cancer cells develop in the blood cells, bone marrow, or lymphatic system, and include leukemia, lymphoma, and multiple myeloma. Patients often require intensive treatments such as high intensity chemotherapy or hematopoietic stem cell transplantation, as well as prolonged hospitalization. As a result, they tend to experience more pronounced declines in muscle strength and endurance during treatment compared with patients with other solid tumors.

However, in Korea, rehabilitation for patients with blood cancers has not been systematically implemented due to the lack of dedicated rehabilitation staff and programs.

In contrast, specific rehabilitation guidelines have been established for patients with solid tumors, such as breast and gynecologic cancers, to address functional impairments that may occur after treatment, including lymphedema and reduced upper limb function.

The research team analyzed changes in physical function before and after rehabilitation in 34 patients with blood cancers who were hospitalized at the Division of Hematology at Asan Medical Center and received rehabilitation between January and December 2025. The patients were also divided into three groups according to the number of rehabilitation sessions they received: fewer than 10 sessions, 10 to 20 sessions, and more than 20 sessions. The team then analyzed differences in functional recovery according to the number of rehabilitation sessions.

The research team established an exercise therapy room within the hematology ward so that patients with blood cancers, who are at high risk of infection, could safely receive rehabilitation without leaving the ward. Rather than applying a standard cancer rehabilitation program, the team developed a customized rehabilitation program tailored to the patients’ low blood counts and physical condition. The program gradually increased exercise intensity, beginning with exercises in a lying position and progressing to sitting, standing, and functional movements.

Physical function before and after rehabilitation was assessed using the Cancer Functional Assessment Scale (cFAS), a 120 point assessment tool that evaluates balance, endurance, and the ability to perform activities of daily living in cancer patients.

As a result, the cFAS score increased from 57.4 to 57.6 points in the group that received fewer than 10 rehabilitation sessions and from 52.8 to 57.5 points in the group that received 10 to 20 sessions. Notably, the group that received more than 20 sessions showed a significant improvement in physical function, with scores increasing from 53.2 to 69.6 points, a 30.8% increase.

Physical function improved across the entire patient group, and the findings showed a trend toward greater functional recovery among patients who received more rehabilitation sessions.

In addition, despite the inclusion of many patients with high-risk blood counts, including thrombocytopenia, no serious complications such as falls or bleeding occurred. This demonstrated that rehabilitation can be safely provided to patients with blood cancers.

Professor Jae Yong Jeon of the Department of Rehabilitation Medicine at Asan Medical Center said, “This study is significant in that it provides evidence that rehabilitation can be safely implemented for patients with blood cancers and that a greater number of rehabilitation sessions may lead to greater functional recovery.” He added, “We expect these findings to serve as practical evidence for future discussions on establishing rehabilitation fees and expanding dedicated staff and programs for patients with blood cancers.”

Professor Jung-Hee Lee of the Division of Hematology at Asan Medical Center said, “Rehabilitation has often been avoided in patients with blood cancers due to concerns about weakened immunity and the risk of infection.” She added, “We hope these findings will help raise awareness that patients with blood cancers can also safely receive rehabilitation and ultimately contribute to improving their quality of life.”

The findings were recently published in the international journal Supportive Care in Cancer.