Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Clinical Trials Unit, Faculty of Medicine, University of Freiburg, Germany.
J Geriatr Oncol. 2021 May;12(4):521-530. doi: 10.1016/j.jgo.2020.11.003. Epub 2020 Nov 20.
Multiple myeloma (MM) is the second most common hematological malignancy. Progression free survival (PFS) and overall survival (OS) have substantially improved, nonetheless MM usually remains incurable. Patients with active disease may be affected by numerous comorbidities, including fatigue, depression and osteolytic lesions, which influence their quality of life (QoL). Albeit, it is known that exercising is beneficial for patients' QoL, few clinical trials are available in patients with MM. We therefore aimed to compare comorbidities and clinical outcome in physically active and inactive patients with MM.
We defined physical activity according to WHO criteria (150 min of moderate activity and two sessions of resistance training/week). We matched 53 physically active patients with 53 controls (for age, gender, cytogenetics, disease stage, and therapy) and compared the cohorts for incidence of comorbidities/MM symptoms (osteolytic lesions, anemia, infections, fatigue, depression, Revised-Myeloma Comorbidity Index [R-MCI]) and clinical outcome (treatment tolerance, responses to therapy, PFS and OS) in a retrospective audit. All patients were newly diagnosed with MM and received autologous stem cell transplantations (ASCT) between 2001 and 2017.
Physically active patients showed superior outcomes in R-MCI (p = 0.0005), fatigue (p = 0.0063), treatment tolerance (p = 0.0258) and hospital stays (p = 0.0072). Furthermore, they showed better treatment responses (p = 0.0366), especially complete remission (CR; p = 0.0018) as well as better OS and PFS.
Physical activity in patients with MM undergoing ASCT seemed associated with better overall clinical outcome. Randomized clinical trials are required to understand the benefits and devise strategies for improving exercising among patients with MM.
多发性骨髓瘤（MM）是第二大常见的血液系统恶性肿瘤。无进展生存期（PFS）和总生存期（OS）有了显著改善，但 MM 通常仍然无法治愈。有活动疾病的患者可能受到多种合并症的影响，包括疲劳、抑郁和溶骨性病变，这会影响他们的生活质量（QoL）。尽管已知运动对患者的 QoL 有益，但针对 MM 患者的临床试验很少。因此，我们旨在比较有和无体力活动的 MM 患者的合并症和临床结局。
我们根据世界卫生组织（WHO）的标准（每周 150 分钟的中度活动和两次阻力训练）来定义体力活动。我们将 53 名有体力活动的患者与 53 名对照者（年龄、性别、细胞遗传学、疾病分期和治疗）相匹配，并在回顾性审计中比较了两组患者的合并症/MM 症状（溶骨性病变、贫血、感染、疲劳、抑郁、修订多发性骨髓瘤合并症指数[R-MCI]）和临床结局（治疗耐受性、对治疗的反应、PFS 和 OS）。所有患者均在 2001 年至 2017 年间被诊断为 MM 并接受了自体干细胞移植（ASCT）。
有体力活动的患者在 R-MCI（p=0.0005）、疲劳（p=0.0063）、治疗耐受性（p=0.0258）和住院时间（p=0.0072）方面的结果更好。此外，他们表现出更好的治疗反应（p=0.0366），特别是完全缓解（CR；p=0.0018）以及更好的 OS 和 PFS。
在接受 ASCT 的 MM 患者中进行体力活动似乎与更好的整体临床结局相关。需要进行随机临床试验以了解益处并制定提高 MM 患者锻炼的策略。
