Rapid Fire Best of the Best Poster Oral Clinical Oncology Society of Australia Annual Scientific Meeting 2022

An individualised exercise intervention improves quality of life for people with multiple myeloma: the MyeEx randomised waitlist-controlled trial (#115)

Jennifer L Nicol 1 2 , Michelle M Hill 3 , Brent Cunningham 1 , Carmel Woodrow 4 , Kirsten Adlard 1 , Peter Mollee 4 5 , Nicholas Weber 6 , Andrew J Nicol 7 , Tina L Skinner 1
  1. School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
  2. QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
  3. UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
  4. Haematology, Division of Cancer, Princess Alexandra Hospital, Brisbane, Queensland, Australia
  5. Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
  6. Haematology, Cancer Care Services, Royal Brisbane and Women's Hospital, Queensland, Australia
  7. Brisbane Clinic for Lymphoma, Myeloma and Leukaemia, Greenslopes Private Hospital, Brisbane, Queensland, Australia

Aims:

New treatments improve survival for people with multiple myeloma (MM), but also result in high symptom burden, functional disabilities, and impaired health-related quality of life (HRQoL). Exercise may improve MM symptoms, however evidence in this understudied population is lacking. The aim of this randomised waitlist-controlled trial was to investigate the influence of a 12-week individualised exercise intervention on HRQoL, as well as MM symptoms, pain, cardiorespiratory fitness, fatigue and neuromuscular strength, in people with MM.

Methods:

People at any stage of MM were randomised to exercise (EX) or wait-list control (CON). The 12-week individualised program included twice-weekly sessions supervised one-on-one by an accredited exercise physiologist, with one additional home-based session prescribed per week. Each 60-minute session consisted of high-intensity interval training, moderate-to-hard muscle strength and bone loading exercises. Outcomes were assessed using validated surveys (EORTC QLQ-C30 with MY20 module, FACT-BP, FACIT-F), cardiopulmonary exercise testing and dynamometry.

Results:

Participants with MM (n=60; mean age 65±9 years; 78% male) presented with lytic lesions (78%) and other skeletal complications (13%; back pain, osteoporosis, osteoarthritis). Twelve participants (20%) withdrew from the study due to medical conditions unrelated to the intervention (n=7) or loss of interest (n=5).

The EX group experienced increases in HRQoL (EORTC QLQ-C30 summary score: +6.3, 95%CI 0.8, 11.9, p=0.03), mediated through improved MM symptoms (EORTC QLQ-MY20: -7.4, 95%CI -15.2, 0.5, p=0.07), bone pain (FACT-BP: +4.4, 95%CI 0.5, 8.3, p=0.03) and cardiorespiratory fitness (V̇O2peak: +3.1, 95%CI 1.4, 4.8, p=0.001) compared to CON. No between-group differences (p>0.05) were observed in general pain, fatigue, or neuromuscular strength.

Conclusion:

A 12-week individualised exercise intervention was effective at improving HRQoL, MM symptoms, bone pain and cardiorespiratory fitness across all disease stages. The findings support the inclusion of exercise as part of standard care to improve the quality of life and health of people with MM.