Optimizing Imaging in Multiple Myeloma | Jens Hillengass, MD | IMS 2023

Hello, my name is Jens Hillinges. I'm the chief of myeloma at Rosseau Park Comprehensive Cancer Center in Buffalo, New York. I'm here at the IMS annual meeting to talk about our project that we are still doing right now, but we presented an abstract and oral presentation here at this meeting about our exercise study in multiple myeloma patients. The study was performed as a pilot study with a fairly small number of patients to get a feeling and to see if it's feasible to do exercise in myeloma patients. The idea came from our patients themselves because they live longer, as you know nowadays, with our new treatments and new diagnostic options. And they asked us what can we do, how can we go back to our normal life from before the diagnosis. And oftentimes part of this is that they would like to go back to the gym, do sports and just enjoy their social life. I could usually, when they asked me, I couldn't really give them very good guidance because there's no scientific data confirming that myeloma patients can go back to the gym. And so what we did is we studied a study where we offered two different cohorts. One cohort was that patients came to our center twice a week for an in-person exercise training, resistance training with a personal trainer for six months. And we measured markers of quality of life, markers of immune function, and also functional markers like strength and mobility before and after this intervention. The other group just got prompts via a wearable device on their wrist, this case a Fitbit device, and we told them to achieve the 150 to 300 recommended active minutes per week. And we evaluated now in this pilot study the first cohort and we saw that there was an improvement of immune markers from before to after the intervention. We evaluated in our patients immune markers before and after the intervention and we saw that there was an improvement that in the sense that the T cells, which are an important part of the immune system, improved in their exhaustion markers. Oftentimes T cells in myeloma patients are exhausted, they cannot do their job very well anymore, and the exercise interventions seem to have a positive effect on these cells. Furthermore, what we presented at this meeting is that the functional markers of our patients got better, things like a so-called C2STAND test where we tested within a period of time how often the patient can stand up from a chair and also a six-minute walk test, how far can a patient walk within six minutes, and other tests like for example also pain assessment. And we saw improvement, significant improvement from before to after this intervention. So we are now doing a further prospective study with more patients where we enroll patients for a virtual exercise training that was all triggered by COVID, but it works very well. We offer a virtual training with our patients also six months, twice a week with a personal trainer via Zoom and we see what these markers do over time. We also look into bone markers, bone strength markers, because we think that resistance training is also helpful for that, and we also look into quality of life.