Exercise program boosts life quality in newly diagnosed patients: Trial
Myeloma patients starting treatment had less depression, fewer side effects
Getting regular exercise can help improve life quality, ease depression, and minimize the risk of medication side effects in people with newly diagnosed multiple myeloma who are starting treatment, according to the results of a small clinical trial that tested a three-month physical activity program.
Further, the study showed fewer hospitalizations and less therapy intolerance among new myeloma patients taking part in the exercise program versus those who did not.
Those involved in physical activities also “showed less fatigue … [and] less depression,” as well as better results on a mobility and balance test, than patients in the control group, the researchers found.
“Our [randomized controlled trial] demonstrated positive effects of [physical activity] on patients’ QoL,” or quality of life, the team wrote, adding that “more sport intervention offers are warranted to advance exercising in [multiple myeloma].”
The study, “A Randomized Controlled ‘REAL-FITNESS’ Trial to Evaluate Physical Activity in Patients With Newly Diagnosed Multiple Myeloma,” was published in the Journal of Cachexia, Sarcopenia and Muscle. The researchers did note limitations due to its small size.
Small trial enrolled 34 people with newly diagnosed myeloma
Multiple myeloma is a type of blood cancer characterized by the uncontrolled proliferation of abnormal plasma cells in the bone marrow. Plasma cells are a type of white blood cell responsible for producing antibodies that help fight infections.
In people with myeloma, these malignant cells accumulate in the bone marrow, interfering with the production of normal blood cells and leading to symptoms such as bone pain, anemia, kidney dysfunction, and increased susceptibility to infections. Because most myeloma patients have masses of cancer cells in more than one bone marrow location, the disease is often called multiple myeloma.
Although modern treatment strategies have significantly improved the prognosis for people with myeloma, the disease remains physically and emotionally challenging. The intensive nature of treatment, along with the symptoms of the disease itself, can lead to a reduced quality of life, especially for those newly diagnosed, studies have shown.
Being regularly physically active has many well-established health benefits for people in the general population. However, according to the researchers, there’s not much solid data on whether exercise can be safely performed by people with myeloma who are starting treatment — or if being more active while undergoing treatment can affect patients’ life quality.
Our results demonstrate the feasibility and safety of a guided exercise intervention [program] during [myeloma] induction treatment.
Now, scientists at the University of Freiburg conducted a small clinical trial to explore the feasibility of exercise for people with myeloma starting treatment.
The study, dubbed REAL-FITNESS (DRKS00022250), enrolled 34 people with newly diagnosed cancer, all of whom underwent a standard initial round of myeloma treatment that included the chemotherapy drug cyclophosphamide, the proteasome inhibitor bortezomib, and the corticosteroid dexamethasone.
During the three months of initial treatment, half of the patients underwent a World Health Organization-compliant exercise program supervised by a trainer. The program included 2.5 hours per week of moderate aerobic exercise — that is, exercise that elevates the heart rate — as well as two weekly sessions of strength training. The other half of patients, serving as the control group, did not receive any specialized exercise guidance.
The results demonstrated that the exercise regime was feasible, with data collected from smartwatches and patient-kept diaries confirming that the exercise group got significantly more exercise than the control group. The exercise program also was safe, with no serious safety issues or accidents reported.
“Our results demonstrate the feasibility and safety of a guided exercise intervention [program] during [myeloma] induction treatment,” the researchers wrote.
Exercise program participants reported better physical life quality
At the end of the study, patients in the exercise group reported significantly better scores on standardized measures of physical life quality, though measures of mental life quality were similar in both groups. Measures of mobility and grip strength also improved significantly more in the exercise group than in the control group.
The exercise group also reported a significant reduction in measures of depression, whereas in the control group, depression scores were largely unchanged over the course of the study. At the end of the study, significantly fewer patients in the exercise group reported clinically significant fatigue, though the researchers noted that the control group had more patients reporting fatigue when the study began.
Rates of side effects related to treatment were significantly lower in the exercise group compared with the control group (6.3% vs. 25%). Patients in the exercise group also were less likely to require dose adjustments or to be hospitalized over the course of the study.
Rates of event-free survival, a composite measure that includes death, disease progression, and serious safety problems, were somewhat lower among patients in the exercise group. However, this difference was not statistically significant, so it is mathematically plausible that the difference could just be random chance.
The researchers noted that this study was probably too small to detect a statistically meaningful difference for event-free survival, and the small number of patients means that all the findings must be interpreted with caution.
“This study suggests numerous positive effects of [physical activity] but lacks statistical power due to … size,” the scientists concluded. Nonetheless, they said these encouraging results warrant further studies to investigate the impacts of exercise programs for newly diagnosed myeloma patients.
About the Author
