P-145: The effect of a 6-week Nordic walking training cycle on myeloma-related blood parameters, vitamin 25(OH)D3 serum concentration and peripheral polyneuropathy symptoms in patients with multiple myeloma

Abstract

<h3>Background</h3> Due to the use of new therapeutic strategies, patients with multiple myeloma (MM) live much longer, hence skeletal and neurological dysfunctions related to MM and advancing age are clinically significant. Properly selected training can bring bone health benefits, both in terms of fitness and blood parameters, as well as contribute to the improvement in the severity of peripheral polyneuropathy symptoms. <h3>Method</h3> The study involved 28 MM patients after therapy in remission were divided into 2 groups: participating in exercise training (NW, n=15) and control group (CG, n=13). Subjects from the NW group participated in moderate intensity Nordic walking training sessions (60-70% of estimated HRmax) for 1 hour, 3 times a week, for 6 weeks. The intensity of performed exercises was monitored in all subjects individually with the use of a heart rate monitor. Venous blood was collected twice in all participants: at baseline before the beginning of the training cycle and after 6 weeks (at the end of training cycle). Myeloma-related parameters and vitamin 25(OH)D3 concentration were analyzed. After completing the training cycle patients were also asked for determination of changes in the severity of symptoms of peripheral polyneuropathy. The research was approved by a local bioethics committee and all subjects voluntarily signed informed consent prior to participation. <h3>Results</h3> The applied training cycle (NW group) significantly increased the number of white blood cells (median by 0.56 103/µl, p=0.01), including neutrophils (by 0.62 103/µl, p=0.05). However, no significant impact of NW training on red cell and platelet parameters was observed. Participation in trainings was associated with a decrease in the serum levels of IgA, IgG and IgM, but only the changes in IgG concentration were statistically significant (by 1 g/l, p=0.017). The training contributed to the decrease in the concentrations of κ free light chains in the blood (by 2.2 mg/l, p=0.001) and the κ/λ ratio (by 0.7, p=0.005). However, no significant changes were observed for the concentrations of λ free light chains, beta-2-microglobulin, or monoclonal protein in serum. Serum 25(OH)D3 concentrations were significantly increased in all patients in the NW group (by 10.1 ng/ml, p<0.001). There were no significant changes in the control group. Additionally, patients with a higher initial 25(OH)D3 serum concentration resulted in an improvement in the peripheral polyneuropathy symptoms which was not observed in control group. <h3>Conclusions</h3> Nordic walking has proven to be a safe form of health training for patients with MM. NW has a positive effect on IgG levels, serum free kappa light chain concentration and κ/λ ratio and the concentration of 25(OH)D3. High initial vitamin 25(OH)D3 serum concentration leads to an improvement in symptoms of peripheral polyneuropathy as a result of participation in Nordic walking training.