A randomized trial of home-based exercise for patients receiving aggressive treatment and epoetin alfa for multiple myeloma: Hemoglobin (Hb), transfusion, fatigue and performance as outcomes

E. A. Coleman, E. Anaissie, S. K. Coon, C. B. Stewart, J. Shaw and B. Barlogie

University of Arkansas for Medical Sciences, Little Rock, AR

Background: Over 60% of patients with multiple myeloma (MM) are anemic (Hb < 12 g/dL) at diagnosis. Nearly all become anemic during aggressive treatment for MM and many require red blood cell (RBC) transfusions. Anemia can contribute to fatigue, the most common and often the most distressing symptom for patients with cancer.

Methods: A randomized trial with repeated measures compared the effects on fatigue and performance of a home-based exercise program that combines aerobic and strength resistance training with a usual care/control condition. Measurements were the Profile of Mood States (POMS) fatigue scale, Functional Assessment of Cancer Therapy - Fatigue (FACT-F) and 6-minute walk test. Patients were newly diagnosed with MM and were enrolled in an aggressive treatment protocol that included tandem peripheral blood stem cell transplants. All patients in the study received epoetin alfa according to an algorithm that allowed increases in Hb up to 15 g/dL before dose reductions or delays. Planned enrollment is 160.

Results: The table below shows data from 82 patients with measurements at baseline just before induction chemotherapy and just before stem cell mobilization. Trends toward less fatigue and better performance are seen in the exercise group compared to the control group.

Conclusions: These preliminary findings suggest exercise therapy during aggressive treatment for MM benefits patients by decreasing their fatigue and improving their performance status.