Search

Objective: Fatty infiltration of skeletal muscle (Myosteatosis) is associated with increased frailty, decreased muscle and mobility function, which seems fairly prevalent in multiple myeloma (MM) patients. This study aimed to determine the prognostic value of myosteatosis assessed by CT for progression-free survival (PFS) and overall survival (OS). Materials and methods: This IRB-approved cohort study included patients with newly diagnosed MM who were treated at a single university hospital and received CT at baseline. Geriatric assessment was performed via International Myeloma Working Group frailty score and Revised Myeloma Comorbidity Index. Myosteatosis was determined through measurement of paravertebral muscle radiodensity. Statistical analyses included uni- and multivariable Cox proportional hazard models and the Kaplan–Meier-method. Results: A total of 226 newly diagnosed MM patients (median age: 65 years [range: 29–89], 63% males, mean BMI: 25 [14–42]) were analyzed. The prevalence of myosteatosis was 51%. Muscle radiodensity was significantly decreased in individuals with International Staging System stage III vs. I (p < 0.001), indicating higher fatty muscle infiltration in patients with advanced disease. Both PFS and OS were significantly decreased in patients with myosteatosis (PFS: median 32.0 months (95% CI 20.5.5–42.2) vs. 66.4 months without myosteatosis (95% CI 42.5-not reached), p <.001); OS: median 58.6 (95% CI 51.3—90.2) vs. not reached, p <.001). Myosteatosis remained an independent predictor of OS in multivariable analyses (HR: 1.98; 95%-CI: 1.20–3.27). Conclusion: Myosteatosis seems fairly prevalent in patients with newly diagnosed MM and associated with impaired overall survival. Prospective clinical trials are required to better understand the role of myosteatosis in MM patients. [ABSTRACT FROM AUTHOR]

Background Multiple myeloma (MM) is the second most common hematological malignancy with its prevalence increasing. Patients with symptomatic MM can show numerous comorbidities, affecting their quality of life (QoL). Physical activity (PA) may improve QoL but is not a standardized intervention of comprehensive cancer centers (CCCs). Since data on the PA of patients with MM are scarce, we aimed to prospectively assess fitness levels and patients' motivation to join PA-interventions at our CCC. Methods We generated an exercise questionnaire to interview consecutive patients MM. We prospectively collected data on (a) past and current PA, defined by the World Health Organization (WHO) recommendations, (b) knowledge on exercise effects, (c) exercise motivation, and (d) willingness to participate in PA-interventions. Demographics, comorbidities, response, progression-free survival (PFS), and overall survival (OS) were assessed in 211 symptomatic patients MM. Results While our patients were elderly and most showed bone involvement, their PA was similar to healthy individuals. Aerobic PA (≥ 60 minutes/week) was performed by 65%, and 25% exercised ≥ 150 minutes/week. WHO PA recommendations were fulfilled by 17% of patients. No sport activities or complete physical inactivity were observed in 35% and 16%, respectively. Notably, 38% were motivated to join MM-specific sport interventions. Self-reported knowledge of PA-induced benefits for patients cancer was high (82%), but only 27% knew which exercises were safe to perform. Conclusion This study provides an overview of the PA of patients MM. Our results suggest that the PA of patients MM might not be much lower than in the age-matched general population. [ABSTRACT FROM AUTHOR]

Background: Because of the various therapeutic options available for multiple myeloma (MM), remarkable interest exists today in individualized therapeutic concepts based on patients' fitness. The main objectives of this study were to compare different comorbidity scores and functional tests with respect to their impact on survival (overall survival [OS] and progression‐free survival [PFS]); develop a time‐efficient, MM‐specific functional assessment (FA); and evaluate changes in patients' FA during treatment. Methods: The authors performed a prospective FA in 266 consecutive patients with MM at their initial diagnosis. This included 5 comorbidity scores and 12 commonly used geriatric functional tests. To evaluate changes in the course of treatment, the authors reassessed these 17 tests after ≥6 months. The entire analysis included 7327 FA tests. Results: On the basis of univariate and multivariate Cox regression analyses, the authors identified 4 of the 17 evaluated scores and functional tests as most relevant: the Revised Myeloma Comorbidity Index (R‐MCI), Activity of Daily Living (ADL), the Mini‐Mental State Examination (MMSE), and the quality‐of‐life 12‐Item Short Form Health Survey Physical Composite Scale (SF‐12 PCS). These showed precise group differences for fit, (intermediate‐fit), and frail patients in OS and PFS: the 3‐year OS rates were 90%, 74%, and 43% via the R‐MCI for fit, intermediate‐fit, and frail patients, respectively (P =.0006); 80% and 66% via the ADL for fit and frail patients, respectively (P =.0159); 78% and 48% via the MMSE for fit and frail patients, respectively (P =.0001); and 86% and 66% via the SF‐12 PCS for fit and frail patients, respectively (P =.0091). In follow‐up analyses, 16 of 17 FA tests improved, mostly in younger patients (<70 years old) and responding patients (partial remission or better). Conclusions: Patients may recover from functional and physical limitations under applied MM therapy. The newly established MM‐specific FA (via the R‐MCI, ADL, MMSE, and SF‐12 PCS) allows a precise evaluation of the prognosis and risk status in MM. Its use may improve treatment tolerability and should be validated to individualize MM treatment decisions in the future. Lay Summary: The authors performed a prospective functional assessment (FA) in 266 consecutive patients with multiple myeloma at their initial diagnosis.On the basis of univariate and multivariate Cox regression analyses, the authors identified 4 of 17 initially evaluated scores and functional tests as most relevant: the Revised Myeloma Comorbidity Index, Activity of Daily Living, the Mini‐Mental State Examination, and the quality‐of‐life 12‐Item Short Form Health Survey Physical Composite Scale.The authors checked the stability of the final model by applying forward and stepwise selection. To evaluate changes in the course of treatment, they reassessed these 17 tests in 165 patients after ≥6 months: 16 of the 17 FA tests improved, mostly in younger patients (<70 years old) and responding patients (partial remission or better). Patients may recover from functional and physical limitations under applied myeloma therapy. A newly established myeloma‐specific functional assessment (via the Revised Myeloma Comorbidity Index, Activity of Daily Living, the Mini‐Mental State Examination, and the 12‐Item Short Form Health Survey Physical Composite Scale) allows a precise evaluation of the prognosis and risk status in multiple myeloma. [ABSTRACT FROM AUTHOR]