Trial to Explore Benefits of Exercise Before Autologous Stem Cell Transplant in Myeloma Patients

Patricia Inácio, PhD avatar

by Patricia Inácio, PhD |

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A new clinical trial will determine if an exercise program before an autologous stem cell transplant can improve treatment-related side effects in multiple myeloma patients.

The trial details are summarized in a report, “Is it feasible to conduct a randomised controlled trial of pretransplant exercise (prehabilitation) for patients with multiple myeloma awaiting autologous haematopoietic stem cell transplantation? Protocol for the PREeMPT study,” published in the journal BMJ Open.

One of the most common treatments for multiple myeloma is an autologous stem cell transplant, a procedure that transplants a patient’s own blood stem cells after being treated with high doses of chemotherapy. In most cases, however, there are adverse effects associated with this treatment.

Recent evidence points to the importance and benefits of exercise for patients recovering from stem cell transplants. It has been suggested that exercise before this treatment — prehabilitation exercise — not only boosts the recovery of the patient, but also has other disease-related benefits. However, no evidence exists for the use of prehabilitation in patients with myeloma.

Researchers are now preparing a trial to determine the feasibility of prehabilitation exercise in patients with myeloma awaiting stem cell transplant. Researchers will invite multiple myeloma patients who are waiting for either a first or second stem cell transplant  to participate in the PREeMPT trial (NCT03135925).

After an initial assessment and data collection, patients who agree to participate in the trial will be evaluated on their exercise capability and complete one set of four questionnaires.

They’ll receive an exercise booklet, as well as advice and supervision of a physiotherapist in their first exercise session. The program will continue for a minimum of six weeks.

After the six-week trial period, patients will complete a repeat set of questionnaires and a walking test. These will be repeated at the time of hospital admission for their transplant and on the day they leave the hospital.

If the study shows that the exercise program is acceptable for patients, researchers will then establish a larger study to test the effectiveness of the program, using the data from this study to predict and establish futures outcomes.

“There is clearly of value in exploring treatment options that may lessen the effects of treatment, particularly those with relatively low associated costs such as exercise prehabilitation,” they said.

Since prehabilitation is a topic of growing interest in other clinical areas, the development of an appropriate protocol and the findings of this study can be of interest to doctors considering prehabilitation in other cancer types, the study concluded.