INTRODUCTION: Individuals diagnosed with a haematological malignancy experience declines in physical function due to malignancy- and treatment-related factors (1-3). Despite evidence supporting the benefit of exercise across the cancer care continuum,(4) exercise engagement remains low in this population (5-6). Understanding the factors influencing exercise engagement is critical to implementing evidence-informed guidelines within routine haematological cancer care.
METHODS: A qualitative systematic review was conducted according to PRISMA guidelines. Seven databases (MEDLINE (EBSCOhost), CINAHL, CENTRAL, ProQuest Central, Scopus, PsycINFO, and Web of Science) were searched for literature published between January 2010 to March 2026. Two reviewers independently screened studies, assessed methodological quality using the Joanna Briggs Institute (JBI) critical appraisal checklist, and extracted data based on exercise motivators, benefits, barriers, facilitators, and preferences. Findings were synthesised using JBI meta-aggregation and interpreted through Integrating-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework (7).
RESULTS: Twenty-four studies representing 484 participants with leukaemia, lymphoma, or multiple myeloma were included, yielding 338 qualitative findings. Individuals consistently valued exercise across the care continuum. Exercise engagement was influenced by the interaction between recipients, context, innovation, and facilitation factors. Facilitation underpinned exercise engagement through healthcare professional endorsement, exercise-specific education, referral pathways, and access to exercise professionals with haematological cancer-specific expertise, while individually tailored exercise (innovation) and flexible delivery (context) supported participation across changing treatment phases.
CONCLUSION: The challenge is no longer whether exercise benefits individuals with a haematological malignancy, but how it can be effectively embedded within routine care. This review provides an implementation-informed foundation for integrating evidence-informed, person-centred exercise care across prehabilitation to survivorship.