title: Exercise is medicine: case report of a woman with smoldering multiple myeloma.
abstract: OBJECTIVE
  This study aimed to evaluate the influence of a supervised training program on the changes in serum monoclonal protein level (i.e., IgG), percentage of bone marrow plasma cells (BMPCs), fitness performance, and cardiac autonomic control (i.e., HR variability [HRV] and HR complexity [HRC]) in a female diagnosed with smoldering multiple myeloma (SMM).
  
  
  METHODS
  A middle-age female patient with smoldering multiple myeloma and former elite athlete was monitored for 4 yr while participating in a supervised multimodal training regimen designed for the development of various physical capacities. The patient had the possibility of self-selection of daily training volume. Changes in fitness components, IgG levels, and BMPCs were evaluated throughout a 4-yr monitoring period (i.e., follow-up). HRV was examined via 24-h HR recordings during a 6-wk period at the second and the third year of the follow-up.
  
  
  RESULTS
  Exercise performance in all fitness components was improved while IgG levels and BMPCs decreased (from 2.53 to 1.84 g · dL(-1) and from 20% to 10%, respectively). Time and frequency domain HRV parameters exhibited significant increases (18%-29%) with HRC remaining unchanged.
  
  
  CONCLUSIONS
  The current case report results indicated that a multimodal training program designed for the development of various physical capacities improved exercise performance, hematological function, and cardiac autonomic control that may improve long-term prognosis for SMM. Examination of similar exercise training regimens for hematological and other cancer populations may assist in the development of simple nonpharmacological treatments for improved prognosis.
authors: Post-Graduate Program in Physical Education, Catholic University of Brasilia, Brasilia, Brazil.
authors: Daniel A
authors: DA
authors: Boullosa
authors: Laurinda
authors: L
authors: Abreu
authors: Lais
authors: L
authors: Tonello
authors: Peter
authors: P
authors: Hofmann
authors: Anthony S
authors: AS
authors: Leicht
mesh_terms: D000328:Adult; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D009101:Multiple Myeloma / Q000628:therapy*