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. 2025 Jun 21;33(7):605.
doi: 10.1007/s00520-025-09612-5.

What are safe hemoglobin, neutrophil and platelet counts for people with hematological malignancies to participate in exercise and activities of daily living: a scoping review

Joanne L Houston  1   2 , Kieran P Boyd  3 , Paul M Gittings  4 , Vinicius Cavalheri  5   6   7
Affiliations

What are safe hemoglobin, neutrophil and platelet counts for people with hematological malignancies to participate in exercise and activities of daily living: a scoping review

Joanne L Houston et al. Support Care Cancer. .

Abstract

Purpose: The aim of this scoping review was to summarize the extent of the literature in relation to safe levels of platelet, hemoglobin and neutrophil count for people with hematological cancers to participate in exercise or activities of daily living (ADLs).

Methods: A comprehensive search for this scoping review was completed in July 2024 across five databases: the Cochrane Library, Embase, PEDro, PubMed and OTSeeker. Original studies, reviews and expert opinion papers were included if they focused on people with active hematological cancer diagnoses or those undergoing treatment affecting bone marrow, and referenced safe levels of platelet, hemoglobin and neutrophil count for exercise or ADLs participation. Papers were included if they were published in English and after the year 2000.

Results: Forty-seven papers were included. Thirty-four were prospective studies, four were retrospective studies, five were reviews and four were expert opinion papers. Forty-four (94%) referenced platelet, 36 (77%) referenced hemoglobin and 17 (36%) referenced neutrophil count. Regarding platelet count, evidence is emerging away from contradicting exercise to adapting exercise and ADLs. Regarding hemoglobin levels, there were much more distinct criteria for cessation or adaptation of exercise/activity. Neutrophil cut-off values focused on minimization of infection risk being the focus when participants were neutropenic.

Conclusions: This scoping review emphasizes that, in people with hematological cancers, evidence for safe levels of blood cells cut-off values for exercise and ADL engagement is evolving, and that prescription of safe exercise and functional rehabilitation is multifactorial.

Keywords: Blood cell; Exercise; Hematological cancer; Occupational therapy; Physical activity; Physiotherapy.

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Conflict of interest statement

Declaration. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram [9]
Fig. 2
Fig. 2
Types of exercise training modalities across the 34 prospective studies. Abbreviations: ADL, activities of daily living; NMES, neuromuscular electrical stimulation
See this image and copyright information in PMC

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