Oncologie et MPR

Le 15/10/2021 de 09:00 à 10:30

Retour Session


Préhabilitation par de l'activité physique mixte chez des patients en cours de chimiothérapie pré-autogreffe de cellules souches hématopoïétiques dans le cadre du traitement d'un myélome multiple : efficace et sûr.

Virgile Pinelli (Toulouse, France), Antoine Cordival (Toulouse, France), Pierre Cerutti (Saint-Orens-de-Gameville, France), Yann Darolles (Saint-Orens-de-Gameville, France), Aurore Perrot (Toulouse, France)

Objectif : Multiple myeloma (MM) concerns 3000 new patients each year in France. Before 68 years, treatment is based on high-intensity chemotherapy requiring auto-HSCT, preceded by several month of induction chemotherapy. Patients have various deficiencies : asthenia, exercise intolerance, pain, peripheral neuropathy, and anxiety, heightened during 3 month following auto-HSCT. Prehabilitation, based on physical activity (PA), allows better tolerance of major oncological procedures, but have never been tried in MM. The aim of our pilot study is to assess it in MM.

Matériel/Patients et méthodes : For this pilot study, 10 patients were addressed by hematologists to OncoRehabilitation Unit, for first cardiopulmonary exercise testing (CPET). With CPET data, patients-tailored home-based 12 weeks prehabilitation program was induced, supervised by a PA teacher. It associated aerobics, strengthening, and stretching exercises. A second CPET were performed before auto-HSCT.

Résultats : Despite Covid-induced delay, all 10 patients are included today. All of them had bone lesions on spine, ribs, or long bones ; back pain; and most of them were sedentary.
All completed the 12 weeks prehabilitation, without any significant adverse effect. Only delayed onset muscle soreness were reported.
Observance was over recommended 3+ sessions a week. Resistance and duration of sessions constantly increased until week 12. CPET data showed a significant increase in oxygen consumption at effort acme and at first ventilatory threshold.

Discussion - Conclusion : Prehabilitation based on PA is feasible, safe, and significantly efficient for patients undergoing inductive chemotherapy for MM. They arrive in better shape to auto-HSCT. Our clinical impression of a better tolerance of graft procedure, with less fatigue and fatigability have to be confirmed by a further study.

Mots clés : Prehabilitation, multiple myeloma, stem cells graft, physical activity

Liens d'intérêts : All prehabilitation programs were funded by industrial partners : Takeda, Celgene, Sanofi, Janssen.