Jens Hillengass, MD, PhD, professor, Oncology and Internal Medicine, chief, Department of Myeloma, Roswell Park Comprehensive Cancer Center, professor of medicine, Division of Hematology and Oncology, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, discusses the rationale for investigating exercise and its effect on functional performance in multiple myeloma, and highlights the methods utilized in this study.

Investigators shared data from patients with multiple myeloma evaluated in this 2-arm, nonrandomized pilot exercise study at the 2023 International Myeloma Symposium

, showing that exercises that included resistance training and walking were safe and effective at improving frailty scores in this patient population. Previous findings from the study revealed a significant enhancement in immune function among participants.

Many patients being treated for cancer desire to regain the active lifestyle that they enjoyed prior to their diagnosis, Hillengass begins. These individuals often seek guidance on how to safely reintroduce physical activity into their lives, Hillengass explains. However, the lack of substantial data in this area, compounded by concerns related to bone disease and the risk of fractures, limits clinicians’ ability to provide patients with conclusive recommendations, Hillengass emphasizes.

In response to this need, investigators launched a prospective study to assess the safety and potential benefits of exercise in this patient group, Hillengass expands. Patients in the pilot study were randomly assigned to 2 distinct subgroups, Hillengass says. The first group participated remotely, in order to account for concerns or challenges associated with the COVID-19 pandemic he notes. These patients were equipped with Fitbit devices and received prompts encouraging them to increase their daily step count and engage in a specific number of active minutes per week from their homes, Hillengass says. The second group participated in a supervised resistance training program, Hillengass explains. These patients attended the investigational treatment center twice a week, where they engaged in exercises specifically designed to enhance muscle strength and improve mobility, Hillengass notes.

Results from this study can better inform the integration of exercise into patients’ lives while accounting for their unique health concerns, Hillengass concludes.

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Jens Hillengass, MD, PhD, discusses the rationale for investigating exercise and its effect on functional performance in multiple myeloma, and highlights the methods utilized in this study. 

Dr Hillengass on the Rationale For Investigating the Effect of Exercise on Functional Performance in Multiple Myeloma 

Jens Hillengass, MD, PhD, professor, Oncology and Internal Medicine, chief, Department of Myeloma, Roswell Park Comprehensive Cancer Center, professor of medicine, Division of Hematology and Oncology, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, discusses the influence of physical activity on functional performance in patients with multiple myeloma, according to results from a 2-arm, nonrandomized pilot exercise study.

For the study, investigators assessed the effects of exercise on frailty scores and patient-reported outcomes (PROs). Study participants were given the option to select 1 of 2 exercise intervention groups. In group 1 (n = 24), participants engaged in supervised resistance training sessions twice a week, which were conducted in person, over a period of 6 months. Group 2 (n = 18) involved behavioral intervention through remote prompts to walk for 150 to 300 minutes per week for 6 months. Notably, 5 patients were unable to complete the trial due to various reasons, including factors related to COVID-19. 

Assessments included the 30-second sit-to-stand test, the 6-minute walk test, the timed up-and-go test, a pain visual analogue scale, and activity measure for post-acute care/basic mobility short form. Various questionnaires were utilized to assess daily functional abilities.

Initial findings from this study were previously presented as a poster at the 2023 ASCO Annual Meeting and revealed significant enhancement in immune function among participants, Hillengass says, adding that certain immune cells displayed reduced exhaustion markers, which is particularly beneficial in advanced stages of myeloma.

Updated data presented at the 2023 International Myeloma Symposium

 confirmed that exercises that included resistance training and walking were safe and effective at improving frailty scores in this population. Patients consistently experienced improvements in mobility performance across all 5 assessments, resulting in a 

 value of 0.01 at the end of the set duration of 6 months. Sustained and enhanced results were observed in the 30-second sit-to-stand test following the intervention, Hillengass adds. However, improvements in mobility with the timed-up-and-go tests observed during the intervention phase were partially reversed post-intervention, and improvements in the 6-minute walk test remained unchanged, Hillengass reports.

Moreover, PROs highlighted enhanced well-being and quality of life among participants, he adds. These questionnaires assessed patients’ ability to engage in daily activities and indicated substantial progress after the intervention.

Overall, these findings underscore the potential benefits of this intervention—not only in terms of immune function but also in improving the overall wellbeing and functional capacity of patients with myeloma, Hillengass concludes.

Jens Hillengass, MD, PhD, professor, discusses the influence of physical activity on functional performance for patients with multiple myeloma, according to results from a 2-arm, nonrandomized pilot exercise study.

Jens Hillengass, MD, PhD

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Dr Hillengass on the Rationale For Investigating the Effect of Exercise on Functional Performance in Multiple Myeloma

Dr Hillengass on the Influence of Exercise on Functional Performance in Multiple Myeloma