NP-110: Physical activity in multiple myeloma: a review of the literature

Abstract

Background One of the major problems Multiple Myeloma (MM) patients suffer from is bone instability and the resulting difficulties that come along with it, such as pain and immobility. Few studies have been performed among this patient group to investigate the effects of physical exercise (PE) on MM patient outcomes like muscle strength, and quality of life, such as fatigue, and pain. Methods A PubMed search was conducted by entering the search terms “Multiple myeloma” + “Exercise” and “Multiple myeloma” + “Physical exercise” and yielded 178 and 218 manuscripts respectively. Limiting the search results to clinical trials left 13 and 14 manuscripts; 7 studies: 1 retrospective chart review, 1 questionnaire study, and 5 prospective clinical trials. The majority of these studies (5) were published in the last decade. Results Due to factors such as small sample size and short time of follow up intervention, the results are mostly unclear. The outcomes of several studies of exercise in MM show that physical exercise is feasible for MM patients preparing for an autologous stem cell transplant. Compared to the control groups, the most active participants show better outcomes, like improvements in their blood counts and in Quality-of-Life parameters such as fatigue, pain, sleep, and mood. In one study, no significant benefits were found for fatigue, muscle strength, and cardiovascular fitness; Investing monetarily in the fitness program for one patient group did not result in less costly treatment afterwards. One trial found that MM patients were in much poorer condition then people in a normative standard group. However, compared to other cancer patients, there were no differences in physical performance tests. Conclusion Some of the reported outcomes of exercise in MM have been promising but need to be substantiated in a broader setting with more diverse participants, for a longer duration and include more endpoints like treatment tolerance, survival, and bone pain amongst others. Due to the disease inherent risk of bone-related complications, an individualized, supervised training protocol could be a preferrable tool. One of the major problems Multiple Myeloma (MM) patients suffer from is bone instability and the resulting difficulties that come along with it, such as pain and immobility. Few studies have been performed among this patient group to investigate the effects of physical exercise (PE) on MM patient outcomes like muscle strength, and quality of life, such as fatigue, and pain. A PubMed search was conducted by entering the search terms “Multiple myeloma” + “Exercise” and “Multiple myeloma” + “Physical exercise” and yielded 178 and 218 manuscripts respectively. Limiting the search results to clinical trials left 13 and 14 manuscripts; 7 studies: 1 retrospective chart review, 1 questionnaire study, and 5 prospective clinical trials. The majority of these studies (5) were published in the last decade. Due to factors such as small sample size and short time of follow up intervention, the results are mostly unclear. The outcomes of several studies of exercise in MM show that physical exercise is feasible for MM patients preparing for an autologous stem cell transplant. Compared to the control groups, the most active participants show better outcomes, like improvements in their blood counts and in Quality-of-Life parameters such as fatigue, pain, sleep, and mood. In one study, no significant benefits were found for fatigue, muscle strength, and cardiovascular fitness; Investing monetarily in the fitness program for one patient group did not result in less costly treatment afterwards. One trial found that MM patients were in much poorer condition then people in a normative standard group. However, compared to other cancer patients, there were no differences in physical performance tests. Some of the reported outcomes of exercise in MM have been promising but need to be substantiated in a broader setting with more diverse participants, for a longer duration and include more endpoints like treatment tolerance, survival, and bone pain amongst others. Due to the disease inherent risk of bone-related complications, an individualized, supervised training protocol could be a preferrable tool.