Title : Exercise rehabilitation in Plasma Cell Leukaemia (PCL): A case study in oncology care
Abstract:
Plasma Cell Leukaemia (PCL) is an aggressive haematological malignancy defined as the presence of 5% or more circulating plasma cells. Prognosis is unfavourable with a median survival rate after treatment being 18 months. However, due to its rarity (1 in 1 million individuals diagnosed per year in the UK) and emerging novel treatments, some may survive longer. Treatment nonetheless can be aggressive and can have debilitating side effects including fatigue, compromised immunity, weight loss/gain, poor appetite and peripheral neuropathy. Cancer Exercise Rehabilitation (CER) is an emerging field with exercise benefits noted to improve physical fitness, functioning, treatment related fatigue and Quality Of Life (QOL). Despite its benefits, CER is not part of standard care within the National Health Service (NHS) but is typically funded by cancer charities and often has strict eligibility criteria. Therefore, the aim of this study was to evaluate the impact of an eight-week structured CER programme on various psychological and physiological parameters on an individual with PLC. Following ethical approval, a 50-year-old caucasian female diagnosed with PLC and Multiple Myeloma (MM) in 2024 was recruited following written informed consent.
The patient completed an 8-week supervised CER programme of 3x weekly aerobic and resistance exercise. At baseline, week 4 and following completion of the programme, various psychological and physiological parameters were measured. Whole-body muscle mass increased from baseline to week 4 by ~7% with a slight reduction observed following the intervention by ~0.8%. Whole-body fat mass decreased from baseline to week 4 by ~5% with a modest regain of ~4% following the intervention. Incremental Shuttle Walk Test (ISWT) performance was improved by 100m at week 4 but the improvement was not sustained following the intervention. General anxiety levels showed small fluctuations over the intervention whereas depression levels initially worsened but improved to a clinically meaningful degree by the end of the intervention. Fatigue levels were slightly elevated at week 4 but reduced below baseline levels by the end of the intervention. In conclusion, the CER programme produced early improvements in whole-body muscle, fat mass and functional capacity but these were not fully sustained by the end. Psychological outcomes improved following completion of the CER programme with the exception of anxiety which remained stable and low across the CER programme.
