Effects of exercise in combination with epoetin alfa during high-dose chemotherapy and autologous peripheral blood stem cell transplantation for multiple myeloma.
OBJECTIVE
To determine the effect of aerobic and strength resistance training and epoetin alfa (EPO) therapy on transfusions, stem cell collections, transplantation recovery, and multiple myeloma treatment response.


METHODS
Randomized clinical trial.


METHODS
A myeloma research and therapy center in the south central United States.


METHODS
135 patients with multiple myeloma, 120 evaluable.


METHODS
Random assignment to exercise or usual care groups. All patients received EPO based on an algorithm. Aerobic capacity, using the six-minute walk test, was assessed prior to induction chemotherapy, prior to stem cell mobilization, and following stem cell collection for all patients and before and after transplantation for patients continuing in the study. Data analysis included analysis of variance to compare other outcome variables by groups.


METHODS
Number of red blood cell and platelet transfusions during transplantation, number of attempts at and total number of days of stem cell collection, time to recovery after transplantation, and response to intensive therapy for multiple myeloma.


RESULTS
Recovery and treatment response were not significantly different between groups after transplantation. The exercise group had significantly fewer red blood cell transfusions and fewer attempts at stem cell collection. Serious adverse events were similar in each group.


CONCLUSIONS
Exercise with prophylactic EPO therapy reduces the number of RBC transfusions and attempts at stem cell collection for patients receiving intensive treatment for multiple myeloma.


CONCLUSIONS
Exercise is safe and has many physiologic benefits for patients receiving multiple myeloma treatment.
Coleman
Elizabeth A
EA
Colleges of Medicine and Nursing, University of Arkansas for Medical Sciences, Little Rock, USA. colemanann@uams.edu
Coon
Sharon K
SK
Kennedy
Robert L
RL
Lockhart
Kimberly D
KD
Stewart
Carol B
CB
Anaissie
Elias J
EJ
Barlogie
Bart
B
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000740:Anemia / Q000209:etiology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000627:therapeutic use; D005047:Etoposide / Q000008:administration & dosage; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D005221:Fatigue / Q000209:etiology; D005260:Female; D006397:Hematinics / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000628:therapy*; D024802:Nurse's Role; D015403:Nursing Evaluation Research; D009859:Oncology Nursing; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods / Q000451:nursing; D011994:Recombinant Proteins; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
D006397:Hematinics; D011994:Recombinant Proteins; D004921:Erythropoietin; D014750:Vincristine; D000068817:Epoetin Alfa; D005047:Etoposide; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin