Benefits of exercise in combination with epoetin alfa for multiple myeloma

Abstract

8605 Background: Epoetin alfa increases hemoglobin levels and reduces the need for RBC transfusions in diverse groups of patients with cancer-related anemia. Interest in other potential benefits led to this study comparing outcomes relative to the duration of epoetin alfa therapy and exercise for patients receiving intensive therapy for multiple myeloma while enrolled in a randomized, controlled trial of a home-based individualized exercise program. Outcomes of interest included the number of attempts at and days of stem cell collection relative to exercise and the time to recovery post transplant, response to treatment, as well as RBC and platelet transfusions relative to the duration of epoetin alfa and exercise. Methods: The patients were enrolled in a treatment protocol consisting of high dose chemotherapy and tandem stem cell transplants. Participants were randomized to exercise (n = 54) or usual care (n = 57) groups as they enrolled in the treatment protocol. Participants in both groups received epoetin alfa according to an algorithm. All participants were in the study for approximately 15 weeks through stem cell collection. Sixty-nine (69) of 70 consecutive eligible patients continued in the study for approximately 15 weeks more through their first transplant. Results: All groups of patients were equivalent for age, gender and race and the exercise and usual care groups were equivalent for duration of epotein alfa. There were non significant findings for post transplant recovery and response to treatment relative to the duration of epoetin alfa therapy and exercise program. Patients who received epoetin alfa for the longer duration had significantly (p < .01) higher mean hemoglobin levels during the transplant period but there was no significant difference at discharge from transplant. Patients in the exercise group had significantly (p < .05) fewer RBC and platelet transfusions and significantly (p < .05) fewer attempts at stem cell collection and total days of collection. Conclusions: These findings suggest that exercise in combination with prophylactic epoetin alfa therapy benefits patients by reducing the number of RBC and platelet transfusions and the number of attempts at and number of days of stem cell collection. [Table: see text]