Intensive Tailored Exercise Training With NAD+ Precursor Supplementation to Improve Muscle Mass and Fitness in Adolescent and Young Adult Hematopoietic Cell Transplant Survivors

What this Trial Is About

Adolescents and young adults (AYAs) who have had hematopoietic cell transplantation (HCT) are at higher risk for early loss of muscle mass, which increases their risk of death and cardiovascular disease. Researchers are studying the effects of a dietary supplement called nicotinamide riboside (NR), a precursor of NAD+, along with a home-based exercise program, on muscle strength and aerobic fitness in AYA HCT survivors. This is a randomized, placebo-controlled trial with a 2x2 factorial design to evaluate these interventions over 16 weeks. Participants will be assigned to one of four groups: NR supplement alone, placebo alone, exercise plus NR, or exercise plus placebo. NR dosing varies by body weight, ranging from 300 mg to 900 mg once daily for 16 weeks. The exercise program includes aerobic and resistance training, aiming for 150-300 minutes of moderate aerobic activity per week and strength training twice weekly. The placebo matches the NR capsules but contains no active supplement. Participants will be monitored for changes in muscle strength using tests like isometric knee extension, ankle plantarflexion, and grip strength. Muscle mass and muscle energy metabolism will also be assessed along with aerobic capacity (VO2 max) from baseline to 16 weeks. Safety and adherence will be tracked, and the study includes multiple assessments over the 16-week period to evaluate the effects of the interventions on muscle quality and fitness.

Exercise Training and NR Supplementation Trial to Improve Fitness in AYA HCT Survivors