The effects of short-term, progressive exercise training on disease activity in smouldering multiple myeloma and monoclonal gammopathy of undetermined significance: a single-arm pilot study

A Emery; S Moore; J Crowe; J Murray; O Peacock; D Thompson; F Betts; S Rapps; L Ross; D Rothschild-Rodriguez; A Arana Echarri; R Davies; R Lewis; DX Augustine; A Whiteway; Z Afzal; JLJ Heaney; MT Drayson; JE Turner; JP Campbell

doi:10.1186/s12885-024-11817-6

The effects of short-term, progressive exercise training on disease activity in smouldering multiple myeloma and monoclonal gammopathy of undetermined significance: a single-arm pilot study

A Emery, S Moore, J Crowe, J Murray, O Peacock, D Thompson, F Betts, S Rapps, L Ross, D Rothschild-Rodriguez, A Arana Echarri, R Davies, R Lewis, DX Augustine, A Whiteway, Z Afzal, JLJ Heaney, MT Drayson, JE Turner, JP Campbell^*

^*Corresponding author for this work

Sport, Exercise and Rehabilitation Sciences

Research output: Contribution to journal › Article › peer-review

5 Downloads (Pure)

Abstract

Background: High levels of physical activity are associated with reduced risk of the blood cancer multiple myeloma (MM). MM is preceded by the asymptomatic stages of monoclonal gammopathy of undetermined significance (MGUS) and smouldering multiple myeloma (SMM) which are clinically managed by watchful waiting. A case study (N = 1) of a former elite athlete aged 44 years previously indicated that a multi-modal exercise programme reversed SMM disease activity. To build from this prior case study, the present pilot study firstly examined if short-term exercise training was feasible and safe for a group of MGUS and SMM patients, and secondly investigated the effects on MGUS/SMM disease activity.

Methods: In this single-arm pilot study, N = 20 participants diagnosed with MGUS or SMM were allocated to receive a 16-week progressive exercise programme. Primary outcome measures were feasibility and safety. Secondary outcomes were pre- to post-exercise training changes to blood biomarkers of MGUS and SMM disease activity– monoclonal (M)-protein and free light chains (FLC)– plus cardiorespiratory and functional fitness, body composition, quality of life, blood immunophenotype, and blood biomarkers of inflammation.

Results: Fifteen (3 MGUS and 12 SMM) participants completed the exercise programme. Adherence was 91 ± 11%. Compliance was 75 ± 25% overall, with a notable decline in compliance at intensities > 70% V̇O_2PEAK. There were no serious adverse events. There were no changes to M-protein (0.0 ± 1.0 g/L, P =.903), involved FLC (+ 1.8 ± 16.8 mg/L, P =.839), or FLC difference (+ 0.2 ± 15.6 mg/L, P =.946) from pre- to post-exercise training. There were pre- to post-exercise training improvements to diastolic blood pressure (− 3 ± 5 mmHg, P =.033), sit-to-stand test performance (+ 5 ± 5 repetitions, P =.002), and energy/fatigue scores (+ 10 ± 15%, P =.026). Other secondary outcomes were unchanged.

Conclusions: A 16-week progressive exercise programme was feasible and safe, but did not reverse MGUS/SMM disease activity, contrasting a prior case study showing that five years of exercise training reversed SMM in a 44-year-old former athlete. Longer exercise interventions should be explored in a group of MGUS/SMM patients, with measurements of disease biomarkers, along with rates of disease progression (i.e., MGUS/SMM to MM). Registration: https://www.isrctn.com/ISRCTN65527208 (14/05/2018).

Original language	English
Article number	174
Number of pages	18
Journal	BMC Cancer
Volume	24
Issue number	1
DOIs	https://doi.org/10.1186/s12885-024-11817-6
Publication status	Published - 5 Feb 2024

Bibliographical note

Funding:
Sources of funding: University of Bath Alumni Fund (provided funding for the purchase of treadmills to deliver the exercise intervention), Physiological Society (provided funding for the purchase of reagents for analysis of biological samples).

Keywords

Resistance exercise
Aerobic exercise
Anti-cancer mechanisms
Cancer risk
Cancer precursors
Exercise oncology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1186/s12885-024-11817-6Licence: Creative Commons: Attribution (CC BY)

EmeryA2024effectsFinal published version, 3.48 MBLicence: Creative Commons: Attribution (CC BY)

Cite this

Emery, A., Moore, S., Crowe, J., Murray, J., Peacock, O., Thompson, D., Betts, F., Rapps, S., Ross, L., Rothschild-Rodriguez, D., Arana Echarri, A., Davies, R., Lewis, R., Augustine, DX., Whiteway, A., Afzal, Z., Heaney, JLJ., Drayson, MT., Turner, JE., & Campbell, JP. (2024). The effects of short-term, progressive exercise training on disease activity in smouldering multiple myeloma and monoclonal gammopathy of undetermined significance: a single-arm pilot study. BMC Cancer, 24(1), Article 174. https://doi.org/10.1186/s12885-024-11817-6

@article{17b0dd55a8ae41849ba58bb18032f896,

title = "The effects of short-term, progressive exercise training on disease activity in smouldering multiple myeloma and monoclonal gammopathy of undetermined significance: a single-arm pilot study",

abstract = "Background: High levels of physical activity are associated with reduced risk of the blood cancer multiple myeloma (MM). MM is preceded by the asymptomatic stages of monoclonal gammopathy of undetermined significance (MGUS) and smouldering multiple myeloma (SMM) which are clinically managed by watchful waiting. A case study (N = 1) of a former elite athlete aged 44 years previously indicated that a multi-modal exercise programme reversed SMM disease activity. To build from this prior case study, the present pilot study firstly examined if short-term exercise training was feasible and safe for a group of MGUS and SMM patients, and secondly investigated the effects on MGUS/SMM disease activity. Methods: In this single-arm pilot study, N = 20 participants diagnosed with MGUS or SMM were allocated to receive a 16-week progressive exercise programme. Primary outcome measures were feasibility and safety. Secondary outcomes were pre- to post-exercise training changes to blood biomarkers of MGUS and SMM disease activity– monoclonal (M)-protein and free light chains (FLC)– plus cardiorespiratory and functional fitness, body composition, quality of life, blood immunophenotype, and blood biomarkers of inflammation. Results: Fifteen (3 MGUS and 12 SMM) participants completed the exercise programme. Adherence was 91 ± 11%. Compliance was 75 ± 25% overall, with a notable decline in compliance at intensities > 70% {\.V}O2PEAK. There were no serious adverse events. There were no changes to M-protein (0.0 ± 1.0 g/L, P =.903), involved FLC (+ 1.8 ± 16.8 mg/L, P =.839), or FLC difference (+ 0.2 ± 15.6 mg/L, P =.946) from pre- to post-exercise training. There were pre- to post-exercise training improvements to diastolic blood pressure (− 3 ± 5 mmHg, P =.033), sit-to-stand test performance (+ 5 ± 5 repetitions, P =.002), and energy/fatigue scores (+ 10 ± 15%, P =.026). Other secondary outcomes were unchanged. Conclusions: A 16-week progressive exercise programme was feasible and safe, but did not reverse MGUS/SMM disease activity, contrasting a prior case study showing that five years of exercise training reversed SMM in a 44-year-old former athlete. Longer exercise interventions should be explored in a group of MGUS/SMM patients, with measurements of disease biomarkers, along with rates of disease progression (i.e., MGUS/SMM to MM). Registration: https://www.isrctn.com/ISRCTN65527208 (14/05/2018).",

keywords = "Resistance exercise, Aerobic exercise, Anti-cancer mechanisms, Cancer risk, Cancer precursors, Exercise oncology",

author = "A Emery and S Moore and J Crowe and J Murray and O Peacock and D Thompson and F Betts and S Rapps and L Ross and D Rothschild-Rodriguez and {Arana Echarri}, A and R Davies and R Lewis and DX Augustine and A Whiteway and Z Afzal and JLJ Heaney and MT Drayson and JE Turner and JP Campbell",

note = "Funding: Sources of funding: University of Bath Alumni Fund (provided funding for the purchase of treadmills to deliver the exercise intervention), Physiological Society (provided funding for the purchase of reagents for analysis of biological samples).",

year = "2024",

month = feb,

day = "5",

doi = "10.1186/s12885-024-11817-6",

language = "English",

volume = "24",

journal = "BMC Cancer",

issn = "1471-2407",

publisher = "Springer",

number = "1",

}

Emery, A, Moore, S, Crowe, J, Murray, J, Peacock, O, Thompson, D, Betts, F, Rapps, S, Ross, L, Rothschild-Rodriguez, D, Arana Echarri, A, Davies, R, Lewis, R, Augustine, DX, Whiteway, A, Afzal, Z, Heaney, JLJ , Drayson, MT , Turner, JE & Campbell, JP 2024, 'The effects of short-term, progressive exercise training on disease activity in smouldering multiple myeloma and monoclonal gammopathy of undetermined significance: a single-arm pilot study', BMC Cancer, vol. 24, no. 1, 174. https://doi.org/10.1186/s12885-024-11817-6

TY - JOUR

T1 - The effects of short-term, progressive exercise training on disease activity in smouldering multiple myeloma and monoclonal gammopathy of undetermined significance

T2 - a single-arm pilot study

AU - Emery, A

AU - Moore, S

AU - Crowe, J

AU - Murray, J

AU - Peacock, O

AU - Thompson, D

AU - Betts, F

AU - Rapps, S

AU - Ross, L

AU - Rothschild-Rodriguez, D

AU - Arana Echarri, A

AU - Davies, R

AU - Lewis, R

AU - Augustine, DX

AU - Whiteway, A

AU - Afzal, Z

AU - Heaney, JLJ

AU - Drayson, MT

AU - Turner, JE

AU - Campbell, JP

N1 - Funding: Sources of funding: University of Bath Alumni Fund (provided funding for the purchase of treadmills to deliver the exercise intervention), Physiological Society (provided funding for the purchase of reagents for analysis of biological samples).

PY - 2024/2/5

Y1 - 2024/2/5

N2 - Background: High levels of physical activity are associated with reduced risk of the blood cancer multiple myeloma (MM). MM is preceded by the asymptomatic stages of monoclonal gammopathy of undetermined significance (MGUS) and smouldering multiple myeloma (SMM) which are clinically managed by watchful waiting. A case study (N = 1) of a former elite athlete aged 44 years previously indicated that a multi-modal exercise programme reversed SMM disease activity. To build from this prior case study, the present pilot study firstly examined if short-term exercise training was feasible and safe for a group of MGUS and SMM patients, and secondly investigated the effects on MGUS/SMM disease activity. Methods: In this single-arm pilot study, N = 20 participants diagnosed with MGUS or SMM were allocated to receive a 16-week progressive exercise programme. Primary outcome measures were feasibility and safety. Secondary outcomes were pre- to post-exercise training changes to blood biomarkers of MGUS and SMM disease activity– monoclonal (M)-protein and free light chains (FLC)– plus cardiorespiratory and functional fitness, body composition, quality of life, blood immunophenotype, and blood biomarkers of inflammation. Results: Fifteen (3 MGUS and 12 SMM) participants completed the exercise programme. Adherence was 91 ± 11%. Compliance was 75 ± 25% overall, with a notable decline in compliance at intensities > 70% V̇O2PEAK. There were no serious adverse events. There were no changes to M-protein (0.0 ± 1.0 g/L, P =.903), involved FLC (+ 1.8 ± 16.8 mg/L, P =.839), or FLC difference (+ 0.2 ± 15.6 mg/L, P =.946) from pre- to post-exercise training. There were pre- to post-exercise training improvements to diastolic blood pressure (− 3 ± 5 mmHg, P =.033), sit-to-stand test performance (+ 5 ± 5 repetitions, P =.002), and energy/fatigue scores (+ 10 ± 15%, P =.026). Other secondary outcomes were unchanged. Conclusions: A 16-week progressive exercise programme was feasible and safe, but did not reverse MGUS/SMM disease activity, contrasting a prior case study showing that five years of exercise training reversed SMM in a 44-year-old former athlete. Longer exercise interventions should be explored in a group of MGUS/SMM patients, with measurements of disease biomarkers, along with rates of disease progression (i.e., MGUS/SMM to MM). Registration: https://www.isrctn.com/ISRCTN65527208 (14/05/2018).

AB - Background: High levels of physical activity are associated with reduced risk of the blood cancer multiple myeloma (MM). MM is preceded by the asymptomatic stages of monoclonal gammopathy of undetermined significance (MGUS) and smouldering multiple myeloma (SMM) which are clinically managed by watchful waiting. A case study (N = 1) of a former elite athlete aged 44 years previously indicated that a multi-modal exercise programme reversed SMM disease activity. To build from this prior case study, the present pilot study firstly examined if short-term exercise training was feasible and safe for a group of MGUS and SMM patients, and secondly investigated the effects on MGUS/SMM disease activity. Methods: In this single-arm pilot study, N = 20 participants diagnosed with MGUS or SMM were allocated to receive a 16-week progressive exercise programme. Primary outcome measures were feasibility and safety. Secondary outcomes were pre- to post-exercise training changes to blood biomarkers of MGUS and SMM disease activity– monoclonal (M)-protein and free light chains (FLC)– plus cardiorespiratory and functional fitness, body composition, quality of life, blood immunophenotype, and blood biomarkers of inflammation. Results: Fifteen (3 MGUS and 12 SMM) participants completed the exercise programme. Adherence was 91 ± 11%. Compliance was 75 ± 25% overall, with a notable decline in compliance at intensities > 70% V̇O2PEAK. There were no serious adverse events. There were no changes to M-protein (0.0 ± 1.0 g/L, P =.903), involved FLC (+ 1.8 ± 16.8 mg/L, P =.839), or FLC difference (+ 0.2 ± 15.6 mg/L, P =.946) from pre- to post-exercise training. There were pre- to post-exercise training improvements to diastolic blood pressure (− 3 ± 5 mmHg, P =.033), sit-to-stand test performance (+ 5 ± 5 repetitions, P =.002), and energy/fatigue scores (+ 10 ± 15%, P =.026). Other secondary outcomes were unchanged. Conclusions: A 16-week progressive exercise programme was feasible and safe, but did not reverse MGUS/SMM disease activity, contrasting a prior case study showing that five years of exercise training reversed SMM in a 44-year-old former athlete. Longer exercise interventions should be explored in a group of MGUS/SMM patients, with measurements of disease biomarkers, along with rates of disease progression (i.e., MGUS/SMM to MM). Registration: https://www.isrctn.com/ISRCTN65527208 (14/05/2018).

KW - Resistance exercise

KW - Aerobic exercise

KW - Anti-cancer mechanisms

KW - Cancer risk

KW - Cancer precursors

KW - Exercise oncology

U2 - 10.1186/s12885-024-11817-6

DO - 10.1186/s12885-024-11817-6

M3 - Article

SN - 1471-2407

VL - 24

JO - BMC Cancer

JF - BMC Cancer

IS - 1

M1 - 174

ER -

The effects of short-term, progressive exercise training on disease activity in smouldering multiple myeloma and monoclonal gammopathy of undetermined significance: a single-arm pilot study

Abstract

Bibliographical note

Keywords

UN SDGs

Access to Document

Fingerprint

Cite this