Aerobic physical exercise for adult patients with haematological malignancies

Knips, Linus; Bergenthal, Nils; Streckmann, Fiona; Monsef, Ina; Elter, Thomas; Skoetz, Nicole

doi:10.1002/14651858.cd009075.pub3

Cited by 60 publications

(80 citation statements)

References 97 publications

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“…Besides these objective measures there are also subjective measures, such as pain which was assessed in this study via EORTC QLQ-C30; however, even the patients in the non-fit group (6MWT values below the individual predicted values) reported pain intensity similar to the reference values. Moreover, besides radiographic findings pain is an important factor for evaluation of spinal stability of cancer lesions [33] and pathological fractures [34,35]. As pain will always be a limiting factor for physical activity and exercise, the symptom pain should be considered when planning exercise groups and treated in a multidisciplinary manner by use of a multimodal approach [19].…”

Section: Discussionmentioning

confidence: 99%

Relevant parameters for recommendations of physical activity in patients suffering from multiple myeloma

Cenik

Kéilani

Hasenöhrl

et al. 2019

Wien Klin Wochenschr

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Purpose This pilot study aimed to describe physical performance, self-reported physical activity, healthrelated quality of life, anxiety and depression in patients who were assigned from Austrian self-help groups for multiple myeloma patients. These parameters were then discussed in the context of clinical decision-making concerning the recommended type of regular physical activity and exercise. Methods Members of the self-help groups were invited to participate. Physical performance and physical activity were assessed with the 6 min walk test (6MWT), handgrip strength test, timed up and go test (TUG), Tinetti performance oriented mobility assessment (POMA), falls efficacy scale (FES), international physical activity questionnaire (IPAQ), health-related quality of life (EORTC QLQ-C30) and the hospital anxiety and depression scale (HADS). Results A total of 40 patients (female:male = 15:25, mean age: 63.8 ± 9.0 years, range 41-80 years) were identified. In total 20 (50%) reached the performance of healthy peers in the tests 6MWT, handgrip strength, TUG and POMA, while 50% showed at least 1 result below the reference value or cutoff point for each test. Self-reported activity levels were high. Patients showed a tendency to overestimate the risk of falling but a case by case analysis revealed a tendency for underestimating the actual performance in the respective tests (TUG, POMA).

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Section: Discussionmentioning

confidence: 99%

Relevant parameters for recommendations of physical activity in patients suffering from multiple myeloma

Cenik

Kéilani

Hasenöhrl

et al. 2019

Wien Klin Wochenschr

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“…Several exercise studies and reviews of various clinical outcomes, including quality of life (QoL), symptom burden, and survival, exist. Most notably, the 2019 Cochrane Review by Knips et al 16 evaluated 18, mostly small, randomized controlled trials (RCTs) for efficacy, safety, and feasibility of aerobic physical exercise in adults with hematologic malignancies. The primary end point of survival was assessed in only 1 RCT, and unlike solid tumor survival, evidence was inconclusive.…”

Section: Exercise and Clinical Outcomes In Hematologic Malignanciesmentioning

confidence: 99%

“…The main conclusion by the authors was the need for larger trials with longer follow-ups. 16 That being said, several smaller disease-specific studies (eg, lymphoma and multiple myeloma) suggest positive trends with increasing physical activity and QoL. [22][23][24] In a study of patients with lymphoma actively undergoing chemotherapy, Streckmann et al 25 conducted an RCT assessing 36 weeks of supervised exercise training consisting of twice weekly balance, endurance, and strength exercises.…”

Section: Exercise and Clinical Outcomes In Hematologic Malignanciesmentioning

confidence: 99%

Impact of exercise on the immune system and outcomes in hematologic malignancies

Sitlinger¹,

Brander²,

Bartlett

2020

Blood Advances

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Exercise is increasingly recognized as important to cancer care. The biology of how exercise improves outcomes is not well understood, however. Studies show that exercise favorably influences the immune system in healthy individuals (neutrophils, monocytes, natural killer cells, T cells, and a number of cytokines). Thus, exercise in patients with hematologic cancer could significantly improve immune function and tumor microenvironment. We performed a literature search and identified 7 studies examining exercise and the immune environment in hematologic malignancies. This review focuses on the role of exercise and physical activity on the immune system in hematologic malignancies and healthy adults.

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“…A recent Cochrane review of 18 randomised clinical trials (RCTs) in survivors of haematological cancers found that most studies were poorly reported, generally of low quality, affected by bias due to contamination as blinding is not possible, and had insufficient follow-up. 6 …”

Section: Introductionmentioning

confidence: 99%

Fatigue, quality of life and physical fitness following an exercise intervention in multiple myeloma survivors (MASCOT): an exploratory randomised Phase 2 trial utilising a modified Zelen design

et al. 2020

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Background Exercise may improve fatigue in multiple myeloma survivors, but trial evidence is limited, and exercise may be perceived as risky in this older patient group with osteolytic bone destruction. Methods In this Phase 2 Zelen trial, multiple myeloma survivors who had completed treatment at least 6 weeks ago, or were on maintenance only, were enrolled in a cohort study and randomly assigned to usual care or a 6-month exercise programme of tailored aerobic and resistance training. Outcome assessors and usual care participants were masked. The primary outcome was the FACIT-F fatigue score with higher scores denoting less fatigue. Results During 2014–2016, 131 participants were randomised 3:1 to intervention ( n = 89) or usual care ( n = 42) to allow for patients declining allocation to the exercise arm. There was no difference between groups in fatigue at 3 months (between-group mean difference: 1.6 [95% CI: −1.1–4.3]) or 6 months (0.3 [95% CI: −2.6–3.1]). Muscle strength improved at 3 months (8.4 kg [95% CI: 0.5–16.3]) and 6 months (10.8 kg [95% CI: 1.2–20.5]). Using per-protocol analysis, cardiovascular fitness improved at 3 months (+1.2 ml/kg/min [95% CI: 0.3–3.7]). In participants with clinical fatigue ( n = 17), there was a trend towards less fatigue with exercise over 6 months (6.3 [95% CI: −0.6–13.3]). There were no serious adverse events. Conclusions Exercise appeared safe and improved muscle strength and cardiovascular fitness, but benefits in fatigue appeared limited to participants with clinical fatigue at baseline. Future studies should focus on patients with clinical fatigue. Clinical trial registration The study was registered with ISRCTN (38480455) and is completed.

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Aerobic physical exercise for adult patients with haematological malignancies

Abstract: Trusted evidence. Informed decisions. Better health.

Cited by 60 publications

References 97 publications

Relevant parameters for recommendations of physical activity in patients suffering from multiple myeloma

Relevant parameters for recommendations of physical activity in patients suffering from multiple myeloma

Impact of exercise on the immune system and outcomes in hematologic malignancies

Fatigue, quality of life and physical fitness following an exercise intervention in multiple myeloma survivors (MASCOT): an exploratory randomised Phase 2 trial utilising a modified Zelen design

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