Effects of exercise training on red blood cell production: implications for anemia

Exercise training can increase total Hb and red cell mass, which enhances oxygen-carrying capacity. The possible underlying mechanisms are proposed to come mainly from bone marrow, including stimulated erythropoiesis with hyperplasia of the hematopoietic bone marrow, improvement of the hematopoietic microenvironment induced by exercise training, and hormone- and cytokine-accelerated erythropoiesis. Anemia is one of the most common medical conditions in chronic disease. The effects of exercise training on counteracting anemia have been explored and evaluated. The results of the research available to date are controversial, and it seems that significant methodological limitations exist. However, exercise training might be a promising, additional, safe and economical method to help improve anemia. There is a need for further investigation into the effects of and guidelines for exercise interventions (especially strength training) in this population of patients, particularly among cancer patients who are undergoing or have undergone chemotherapy or radiation treatments. As the available data are limited, additional research to uncover the underlying mechanisms associated with the effects of exercise training on anemia is clearly warranted.