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% 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).
BACKGROUND: https://www.isrctn.com/ISRCTN65527208 (14/05/2018).
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).
BACKGROUND: https://www.isrctn.com/ISRCTN65527208 (14/05/2018).
摘要：
背景：高水平的体力活动与血癌多发性骨髓瘤（MM）的风险降低相关。MM之前是无症状的无症状阶段，即意义不明的单克隆丙种球蛋白病（MGUS）和阴燃的多发性骨髓瘤（SMM），可通过观察等待进行临床治疗。先前44岁的前精英运动员的案例研究（N=1）表明，多模式锻炼计划逆转了SMM疾病活动。从之前的案例研究来看，本试点研究首先检查了短期运动训练对一组MGUS和SMM患者是否可行和安全，其次研究了对MGUS/SMM疾病活动的影响。
方法：在这项单臂试点研究中，N=20名诊断为MGUS或SMM的参与者被分配接受16周的渐进式锻炼计划。主要结果指标是可行性和安全性。次要结果是运动训练前后MGUS和SMM疾病活动的血液生物标志物的变化-单克隆（M）蛋白和游离轻链（FLC）-加上心肺和功能适应性。身体成分,生活质量,血液免疫表型，和炎症的血液生物标志物。
结果：15名（3名MGUS和12名SMM）参与者完成了锻炼计划。依从性为91±11%。总体合规性为75±25%，在强度>70%时，依从性显着下降。无严重不良事件发生。M蛋白无变化（0.0±1.0g/L，P=.903），涉及FLC（+1.8±16.8mg/L，P=.839)，或FLC差异（+0.2±15.6mg/L，P=.946）从运动前训练到运动后训练。运动前后训练对舒张压有改善（-3±5mmHg，P=.033)，坐立试验性能(+5±5次重复，P=.002)，和能量/疲劳评分（+10±15%，P=.026）。其他次要结果没有变化。
结论：16周的渐进式锻炼计划是可行且安全的，但没有逆转MGUS/SMM疾病活动，与先前的案例研究相比，该案例研究表明，五年的运动训练逆转了一名44岁的前运动员的SMM。应在一组MGUS/SMM患者中探索更长的运动干预措施，通过测量疾病生物标志物，以及疾病进展率(即，MGUS/SMM到MM）。
背景：https://www.isrctn.com/ISRCTN65527208（2018年5月14日）。
方法：在这项单臂试点研究中，N=20名诊断为MGUS或SMM的参与者被分配接受16周的渐进式锻炼计划。主要结果指标是可行性和安全性。次要结果是运动训练前后MGUS和SMM疾病活动的血液生物标志物的变化-单克隆（M）蛋白和游离轻链（FLC）-加上心肺和功能适应性。身体成分,生活质量,血液免疫表型，和炎症的血液生物标志物。
结果：15名（3名MGUS和12名SMM）参与者完成了锻炼计划。依从性为91±11%。总体合规性为75±25%，在强度>70%时，依从性显着下降。无严重不良事件发生。M蛋白无变化（0.0±1.0g/L，P=.903），涉及FLC（+1.8±16.8mg/L，P=.839)，或FLC差异（+0.2±15.6mg/L，P=.946）从运动前训练到运动后训练。运动前后训练对舒张压有改善（-3±5mmHg，P=.033)，坐立试验性能(+5±5次重复，P=.002)，和能量/疲劳评分（+10±15%，P=.026）。其他次要结果没有变化。
结论：16周的渐进式锻炼计划是可行且安全的，但没有逆转MGUS/SMM疾病活动，与先前的案例研究相比，该案例研究表明，五年的运动训练逆转了一名44岁的前运动员的SMM。应在一组MGUS/SMM患者中探索更长的运动干预措施，通过测量疾病生物标志物，以及疾病进展率(即，MGUS/SMM到MM）。
背景：https://www.isrctn.com/ISRCTN65527208（2018年5月14日）。
