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Joseph JM, Hillengass M, Cannioto R, Tario JD, Wallace PK, Attwood K, Groman A, Jacobson H, Wittmeyer B, Mohammadpour H, Abrams SI, Moysich KB, Hillengass J. T Cell Exhaustion Markers in Multiple Myeloma Patients are Lower After Physical Activity Intervention. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2024:S2152-2650(24)00153-8. [PMID: 38762420 DOI: 10.1016/j.clml.2024.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/10/2024] [Accepted: 04/13/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE There is compelling evidence that CD4+ and CD8+T cells are dysfunctional in multiple myeloma, compromising their ability to control disease progression. Pre-clinical models suggest that exercise represents a non-pharmacologic means to reduce immune exhaustion, but no studies to date have examined the relationship between an exercise intervention and biomarkers of immune exhaustion in multiple myeloma patients. PATIENTS AND METHODS The current study includes 24 multiple myeloma patients who participated in a six-month physical activity intervention, consisting of supervised strength training (n = 12) and unsupervised home-based walking arms (n = 12). Comprehensive flow cytometry was utilized to assess the frequency of CD4+ and CD8+T cells and subpopulations expressing the markers of exhaustion PD-1, TIGIT, TIM3 and/or LAG3. Ratios of exhausted to non-exhausted cell populations, and percentages of exhausted to total populations of the same lineage, were calculated for the baseline and final timepoints. RESULTS Eighteen of 20 exhaustion measures were lower at the end of the intervention than at baseline, and several were significantly or borderline significantly reduced in the entire sample or in one of the arms. The entire sample saw improvements in the ratios of CD4+ TIGIT+ to non-exhausted CD4+ (0.7 [0.6] to 0.6 [0.4], P = .04) and CD8+ PD1+ to non-exhausted CD8+ (1.8 [2.6] to 1.5 [2.0], P = .06), and in total exhausted CD8+ as a percent of total CD8+ (72.9 [21.9] to 68.3 [19.6], P < .01). CONCLUSIONS This pilot study suggests that physical activity induces changes in MM patients' immune systems, potentially rendering a less exhausted T cell state.
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Affiliation(s)
- Janine M Joseph
- Roswell Park Comprehensive Cancer Center, Department of Cancer Prevention and Control, Buffalo, NY.
| | - Michaela Hillengass
- Roswell Park Comprehensive Cancer Center, Department of Cancer Prevention and Control, Buffalo, NY
| | - Rikki Cannioto
- Roswell Park Comprehensive Cancer Center, Department of Cancer Prevention and Control, Buffalo, NY
| | - Joseph D Tario
- Roswell Park Comprehensive Cancer Center, Department of Flow Cytometry Laboratory (Clinical), Buffalo, NY
| | - Paul K Wallace
- Roswell Park Comprehensive Cancer Center, Department of Cell Stress Biology, Buffalo, NY
| | - Kristopher Attwood
- Roswell Park Comprehensive Cancer Center, Department of Biostatistics and Bioinformatics, Buffalo, NY
| | - Adrienne Groman
- Roswell Park Comprehensive Cancer Center, Department of Biostatistics and Bioinformatics, Buffalo, NY
| | - Hillary Jacobson
- Roswell Park Comprehensive Cancer Center, Department of Physical Therapy, Buffalo, NY
| | - Bryan Wittmeyer
- Roswell Park Comprehensive Cancer Center, Department of Physical Therapy, Buffalo, NY
| | - Hemn Mohammadpour
- Roswell Park Comprehensive Cancer Center, Department of Cell Stress Biology, Buffalo, NY
| | - Scott I Abrams
- Roswell Park Comprehensive Cancer Center, Department of Immunology, Buffalo, NY
| | - Kirsten B Moysich
- Roswell Park Comprehensive Cancer Center, Department of Cancer Prevention and Control, Buffalo, NY
| | - Jens Hillengass
- Roswell Park Comprehensive Cancer Center, Department of Medicine - Myeloma, Buffalo, NY
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Lee DJ, El-Khoury H, Tramontano AC, Alberge JB, Perry J, Davis MI, Horowitz E, Redd R, Sakrikar D, Barnidge D, Perkins MC, Harding S, Mucci L, Rebbeck TR, Ghobrial IM, Marinac CR. Mass spectrometry-detected MGUS is associated with obesity and other novel modifiable risk factors in a high-risk population. Blood Adv 2024; 8:1737-1746. [PMID: 38212245 PMCID: PMC10997907 DOI: 10.1182/bloodadvances.2023010843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/31/2023] [Accepted: 11/11/2023] [Indexed: 01/13/2024] Open
Abstract
ABSTRACT Monoclonal gammopathy of undetermined significance (MGUS) is a premalignant condition of multiple myeloma with few known risk factors. The emergence of mass spectrometry (MS) for the detection of MGUS has provided new opportunities to evaluate its risk factors. In total, 2628 individuals at elevated risk for multiple myeloma were enrolled in a screening study and completed an exposure survey (PROMISE trial). Participant samples were screened by MS, and monoclonal proteins (M-proteins) with concentrations of ≥0.2 g/L were categorized as MS-MGUS. Multivariable logistic models evaluated associations between exposures and MS outcomes. Compared with normal weight (body mass index [BMI] of 18.5 to <25 kg/m2), obesity (BMI of ≥30 kg/m2) was associated with MS-MGUS, adjusting for age, sex, Black race, education, and income (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.21-2.47; P = .003). High physical activity (≥73.5 metabolic equivalent of task (MET)-hours per week vs <10.5 MET-hours per week) had a decreased likelihood of MS-MGUS (OR, 0.45, 95% CI, 0.24-0.80; P = .009), whereas heavy smoking and short sleep had increased likelihood of MS-MGUS (>30 pack-years vs never smoker: OR, 2.19; 95% CI, 1.24-3.74; P = .005, and sleep <6 vs ≥6 hours per day: OR, 2.11; 95% CI, 1.26-3.42; P = .003). In the analysis of all MS-detected monoclonal gammopathies, which are inclusive of M-proteins with concentrations of <0.2 g/L, elevated BMI and smoking were associated with all MS-positive cases. Findings suggest MS-detected monoclonal gammopathies are associated with a broader range of modifiable risk factors than what has been previously identified. This trial was registered at www.clinicaltrials.gov as #NCT03689595.
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Affiliation(s)
- David J. Lee
- Department of Medicine, Massachusetts General Hospital, Boston, MA
- Harvard Medical School, Boston, MA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Habib El-Khoury
- Harvard Medical School, Boston, MA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | - Jean-Baptiste Alberge
- Harvard Medical School, Boston, MA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Jacqueline Perry
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Maya I. Davis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Erica Horowitz
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Robert Redd
- Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA
| | | | | | | | | | - Lorelei Mucci
- Harvard T.H. Chan School of Public Health, Boston, MA
| | - Timothy R. Rebbeck
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA
- Harvard T.H. Chan School of Public Health, Boston, MA
| | - Irene M. Ghobrial
- Harvard Medical School, Boston, MA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Center for Early Detection and Interception of Blood Cancers, Dana-Farber Cancer Institute, Boston, MA
| | - Catherine R. Marinac
- Harvard Medical School, Boston, MA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Center for Early Detection and Interception of Blood Cancers, Dana-Farber Cancer Institute, Boston, MA
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Meloni F, Benavente Y, Becker N, Delphine C, Foretova L, Maynadié M, Nieters A, Staines A, Trobbiani C, Pilia I, Zucca M, Cocco P. Lifetime occupational and recreational physical activity and risk of lymphoma subtypes. Results from the European Epilymph case-control study. Cancer Epidemiol 2023; 87:102495. [PMID: 37992416 DOI: 10.1016/j.canep.2023.102495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/08/2023] [Accepted: 11/10/2023] [Indexed: 11/24/2023]
Abstract
Physical activity is known to convey protection against several cancers. However, results on the risk of lymphoma overall and its subtypes have been inconsistent. The aim of this study was to investigate occupational and recreational physical activity in relation to risk of lymphoma subtypes adjusting for established occupational risk factors. We applied standardized tools to assess energy expenditure at work and in recreational physical activities to the questionnaire information on lifetime work and exercise history in 1117 lymphoma cases, including Hodgkin lymphoma, and B-cell (including chronic lymphocytic leukemia, and multiple myeloma) and T-cell non-Hodgkin's lymphoma (NHL) subtypes, and 1207 controls who took part in the multicentre European EpiLymph case-control study. We calculated the risk of lymphoma (all subtypes), B-cell NHL and its most represented subtypes, and Hodgkin's lymphoma (all subtypes) associated with weekly average Metabolic Equivalent of Task (MET-hours/week) and cumulative MET-hours of lifetime recreational, occupational, and total physical activity, with unconditional logistic regression and polytomous regression analysis adjusting by age, centre, sex, education, body mass index, history of farm work and solvent use. We observed an inverse association of occupational, and total physical activity with risk of lymphoma (all subtypes), and B-cell non-Hodgkin's lymphoma among women, and an upward trend in risk of Hodgkin's lymphoma with recreational and total physical activity among men, for which we cannot exclude chance or bias. Our results suggest no effect of overall physical activity on risk of lymphoma and its subtypes.
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Affiliation(s)
- Federico Meloni
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | | | | | - Lenka Foretova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute and MF MU, Brno, Czech Republic
| | | | | | | | - Carlotta Trobbiani
- Occupational Medicine Residency Program, University of Milan, Milan, Italy
| | - Ilaria Pilia
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Mariagrazia Zucca
- Unit of Laboratory Medicine, Sulcis Local Health Unit, Carbonia, SU, Italy
| | - Pierluigi Cocco
- Centre for Occupational and Environmental Health, Division of Population Studies, Healthcare Research & Primary Care, Faculty of Health Sciences, University of Manchester, UK.
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Granger CL. Physiotherapy management of blood cancers. J Physiother 2023; 69:70-78. [PMID: 36958978 DOI: 10.1016/j.jphys.2023.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 02/27/2023] [Indexed: 03/25/2023] Open
Affiliation(s)
- Catherine L Granger
- Department of Physiotherapy, The University of Melbourne, Melbourne, Australia; Department of Physiotherapy, The Royal Melbourne Hospital, Melbourne, Australia.
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Boyle T, Kleinstern G, Bracci PM, Cerhan JR, Benavente Y, Casabonne D, Chiu BCH, Habermann TM, Holly EA, Liebow M, Norman A, Paltiel O, Robinson D, Rothman N, Abu Seir R, Slager SL, Villeneuve PJ, Wang SS, Weisenburger DD, Spinelli JJ. Physical activity and the risk of non-Hodgkin lymphoma subtypes: A pooled analysis. Int J Cancer 2023; 152:396-407. [PMID: 36054546 DOI: 10.1002/ijc.34266] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 03/03/2022] [Accepted: 03/21/2022] [Indexed: 02/01/2023]
Abstract
Non-Hodgkin lymphoma (NHL) is composed of a heterogeneous collection of subtypes with considerable differences in genetics, biology and aetiology. Studies to date on physical activity and NHL risk have not had sufficient sample size to evaluate whether associations differ by subtype. We pooled data from nine case-control studies to examine the association between moderate-to-vigorous intensity physical activity (MVPA) and risk of NHL overall and by subtype (diffuse large B-cell lymphoma, follicular lymphoma, chronic lymphocytic leukaemia/small lymphocytic lymphoma, marginal zone lymphoma and mature T-cell lymphoma). A total of 5653 cases and 9115 controls were included in the pooled analysis. Physical activity was harmonised across nine studies and modelled as study-specific tertiles. Multinomial logistic regression was used to estimate the association between physical activity and NHL, adjusting for confounders. The overall odds of NHL was 13% lower among participants in the most active tertile of MVPA compared to the least active tertile (adjusted odds ratio = 0.87, 95% CI = 0.80, 0.95). Similar decreases were observed across NHL subtypes. In summary, in this pooled analysis of case-control studies, physical activity was associated with a modest risk reduction for each NHL subtype examined and with overall NHL.
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Affiliation(s)
- Terry Boyle
- Australian Centre for Precision Health, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.,Cancer Control Research, BC Cancer Agency, Vancouver, British Columbia, Canada.,School of Public Health, Curtin University, Perth, Western Australia, Australia
| | | | - Paige M Bracci
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - James R Cerhan
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Yolanda Benavente
- Unit of Molecular and Genetic Epidemiology in Infections and Cancer (UNIC-Molecular), Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Hospitalet De Llobregat, Spain.,Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP, Madrid, Spain
| | - Delphine Casabonne
- Unit of Molecular and Genetic Epidemiology in Infections and Cancer (UNIC-Molecular), Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, Hospitalet De Llobregat, Spain.,Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP, Madrid, Spain
| | - Brian C-H Chiu
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, USA
| | | | - Elizabeth A Holly
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Mark Liebow
- Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Aaron Norman
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Ora Paltiel
- Braun School of Public Health and Community Medicine, Hadassah-Hebrew University, Jerusalem, Israel.,Department of Hematology, Hadassah-Hebrew University, Jerusalem, Israel
| | - Dennis Robinson
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Rania Abu Seir
- Department of Medical Laboratory Sciences, Faculty of Health Professions, Al-Quds University, Palestine
| | - Susan L Slager
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Paul J Villeneuve
- School of Mathematics and Statistics and Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada
| | - Sophia S Wang
- Department of Health Analytics, Division of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope, Duarte, California, USA
| | - Dennis D Weisenburger
- Department of Pathology, City of Hope National Medical Center, Duarte, California, USA
| | - John J Spinelli
- Cancer Control Research, BC Cancer Agency, Vancouver, British Columbia, Canada
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6
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Jeon KH, Jeong SM, Shin DW, Han K, Kim D, Yoo JE, Choi T. Associations between alcohol consumption patterns and risk of multiple myeloma: A nationwide cohort study in South Korea. Cancer Epidemiol Biomarkers Prev 2021; 31:670-678. [PMID: 34937793 DOI: 10.1158/1055-9965.epi-21-0904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 10/27/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Among the potential modifiable risk factors, the association between alcohol consumption and the risk of multiple myeloma (MM) remains controversial. We investigated the effects of weekly average alcohol consumption and drinking pattern on the risk of MM using a nationwide representative database. METHODS We identified 11,737,467 subjects who participated in the Korean national health screening program in 2009-2010. Cox regression analyses were performed to calculate the risk of MM according to weekly alcohol consumption, drinking frequency, and amount per session. RESULTS During a mean follow-up period of 6.8 years after a one-year time lag, 6,981 subjects (3,921 men and 3,060 women) were diagnosed with MM. Compared with non-drinkers, all drinkers were at a significantly lower risk for MM. The risk of MM was reduced in a dose-dependent manner: mild drinkers, adjusted hazard ratio (aHR) 0.89, 95% confidence interval (CI) 0.84-0.95; moderate drinkers, aHR 0.83, 95% CI 0.76-0.91; and heavy drinkers, aHR 0.76, 95% CI 0.69-0.85. Furthermore, both drinking frequency and amount per drinking session showed inverse association with the risk of MM. CONCLUSIONS Our large population-based study suggested an inverse dose-dependent association between total average alcohol consumption and the risk of MM, and drinking frequency and amount per drinking session seemed to not differ in their relative contribution to the risk of MM. IMPACT Based on the unprecedently large number of study population analyzed in this study, our study provides solid epidemiologic evidence of alcohol consumption on MM risk.
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Affiliation(s)
- Keun Hye Jeon
- Department of Family Medicine, CHA Gumi Medical Center, CHA University, Gumi, Republic of Korea
| | - Su-Min Jeong
- Supportive Care Center/Department of Family Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Dong Wook Shin
- Supportive Care Center/Department of Family Medicine, Samsung Medical Center, Seoul, Republic of Korea
- Department of Clinical Research Design & Evaluation/Department of Digital Health, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Dahye Kim
- Department of Medical Statistics, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jung Eun Yoo
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - Taewoong Choi
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
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7
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Lipid Level, Lipid Variability, and Risk of Multiple Myeloma: A Nationwide Population-Based Study of 3,527,776 Subjects. Cancers (Basel) 2021; 13:cancers13030540. [PMID: 33572660 PMCID: PMC7866996 DOI: 10.3390/cancers13030540] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 12/24/2022] Open
Abstract
Simple Summary There is preclinical evidence that abnormalities in lipid metabolism promote cancer development, and a few studies show the association between lipid levels and multiple myeloma (MM). However, to our knowledge, the role of lipid variability as a risk factor for MM has not been evaluated. We investigated whether lipid level and its variability are associated with the development of MM at a population level. Lower baseline lipid levels of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglycerides, and high variability in high-density lipoprotein cholesterol were all associated with increased risk of developing MM. These findings support the role of lipid metabolism in MM risk. Abstract (1) Background: There is evidence that abnormality in lipid metabolism promotes cancer development. This study investigated whether lipid level and its variability are associated with the development of MM at a population level. (2) Methods: A retrospective cohort study included a total of 3,527,776 subjects aged 40 and above who participated in ≥3 health examinations within the previous five years, including the index year (2012–2013). Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) were measured, and visit-to-visit lipid variability were calculated by variability independent of the mean (VIM) method. The study population was followed from the health examination date in the index year until the diagnosis of MM, death, or the last follow-up date (31 December 2017). (3) Results: During a median (5–95%) 5.1 years of follow-up, 969 subjects developed MM. A lower risk of MM was observed with higher quartiles of baseline lipid levels compared to the lowest quartile group (Q4 vs. Q1: adjusted hazard ratios (aHRs) 0.51, 95% confidence interval (CI) (0.42–0.61) for TC; 0.50 (0.41–0.61) for HDL-C; 0.65 (0.54–0.77) for LDL-C; and 0.72 (0.60–0.87) for TG in model (3). Among all lipid measures, only variability in HDL-C was associated with risk of MM: aHRs (95% CI) were 1.12 (0.91–1.38), 1.19 (0.97–1.46), and 1.34 (1.09–1.65) in the Q2, Q3, and Q4, respectively, compared to the Q1 of VIM of HDL-C. (4) Conclusions: This study shows that patients with lower lipid levels and high HDL-C variability are at increased risk of developing MM.
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8
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Davies GA, Strader C, Chibbar R, Papatheodorou S, Dmytriw AA. The relationship between physical activity and lymphoma: a systematic review and meta analysis. BMC Cancer 2020; 20:962. [PMID: 33023529 PMCID: PMC7539461 DOI: 10.1186/s12885-020-07431-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/16/2020] [Indexed: 01/08/2023] Open
Abstract
Background The literature suggests an increased risk between anthropometrics including higher body mass index and lymphoma incidence; however, the association with physical activity remains unclear. A systematic review/meta-analysis was therefore performed to examine this association with physical activity (total, recreational or occupational). Methods PubMed, Web of Science and Embase were reviewed from inception to October 2019 identifying relevant observational studies. Non-Hodgkin lymphoma (NHL) including subtypes diffuse large B cell lymphoma, follicular lymphoma and chronic lymphocytic leukemia/small lymphocytic lymphoma, and Hodgkin lymphoma (HL) were analyzed. Included studies reported activity, lymphoma cases, effect size and variability measures, and were restricted to human subjects of any age. Data was pooled generating summary relative risk (RR) estimates with 95% confidence intervals (CI) using random-effects models with primary outcome of histologically confirmed incident lymphoma. Results One thousand four hundred studies were initially identified with 18 studies (nine cohort, nine case-control) included in final analysis. Comparing highest vs. lowest activity categories was protective for all lymphoma (RR 0.89, 95%CI 0.81–0.98). Sensitivity analysis demonstrated effect persistence within case-control studies (RR 0.82, 95% CI 0.71–0.96), but not cohort studies (RR 0.95, 95%CI 0.84–1.07). Borderline protective effect was seen for NHL (RR 0.92, 95%CI 0.84–1.00), but not HL (RR 0.72, 95%CI 0.50–1.04). Analysis by NHL subtype or gender showed no effect. Dose response analysis demonstrated a protective effect (p = 0.034) with a 1% risk reduction per 3 MET hours/week (RR 0.99, 95%CI 0.98–1.00). Conclusions Physical activity may have a protective effect against lymphoma development; further studies are required to generate recommendations regarding health policy. Trial registration This study was registered prospectively at PROSPERO: CRD42020156242.
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Affiliation(s)
- Gwynivere A Davies
- Department of Oncology, Juravinski Cancer Centre- Hamilton Health Sciences, Hamilton, ON, Canada.
| | - Christopher Strader
- Department of Surgery, University of Massachusetts Medical Center, Worchester, MA, Canada
| | - Richa Chibbar
- Digestive Disease Center, Beth Israel Lahey Health, Harvard Medical School, Boston, MA, USA
| | | | - Adam A Dmytriw
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
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9
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Patel AV, Friedenreich CM, Moore SC, Hayes SC, Silver JK, Campbell KL, Winters-Stone K, Gerber LH, George SM, Fulton JE, Denlinger C, Morris GS, Hue T, Schmitz KH, Matthews CE. American College of Sports Medicine Roundtable Report on Physical Activity, Sedentary Behavior, and Cancer Prevention and Control. Med Sci Sports Exerc 2020; 51:2391-2402. [PMID: 31626056 DOI: 10.1249/mss.0000000000002117] [Citation(s) in RCA: 393] [Impact Index Per Article: 98.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The American College of Sports Medicine convened an International Multidisciplinary Roundtable on Exercise and Cancer in March 2018 to evaluate and translate the evidence linking physical activity and cancer prevention, treatment, and control. This article discusses findings from the Roundtable in relation to the biologic and epidemiologic evidence for the role of physical activity in cancer prevention and survival. RESULTS The evidence supports that there are a number of biologically plausible mechanisms, whereby physical activity can influence cancer risk, and that physical activity is beneficial for the prevention of several types of cancer including breast, colon, endometrial, kidney, bladder, esophageal, and stomach. Minimizing time spent in sedentary behavior may also lower risk of endometrial, colon and lung cancers. Conversely, physical activity is associated with higher risk of melanoma, a serious form of skin cancer. Further, physical activity before and after a cancer diagnosis is also likely to be relevant for improved survival for those diagnosed with breast and colon cancer; with data suggesting that postdiagnosis physical activity provides greater mortality benefits than prediagnosis physical activity. CONCLUSIONS Collectively, there is consistent, compelling evidence that physical activity plays a role in preventing many types of cancer and for improving longevity among cancer survivors, although the evidence related to higher risk of melanoma demonstrates the importance of sun safe practices while being physically active. Together, these findings underscore the importance of physical activity in cancer prevention and control. Fitness and public health professionals and health care providers worldwide are encouraged to spread the message to the general population and cancer survivors to be physically active as their age, abilities, and cancer status will allow.
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Affiliation(s)
- Alpa V Patel
- Behavioral and Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | - Christine M Friedenreich
- Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Sciences, Calgary, CANADA
| | - Steven C Moore
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Sandra C Hayes
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, AUSTRALIA
| | - Julie K Silver
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA
| | - Kristin L Campbell
- Department of Physical Therapy, University of British Columbia, Vancouver, CANADA
| | | | | | - Stephanie M George
- Office of Disease Prevention, National Institutes of Health, Bethesda, MD
| | - Janet E Fulton
- Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA
| | - Crystal Denlinger
- Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA
| | | | | | - Kathryn H Schmitz
- Department of Public Health Sciences, Penn State College of Medicine, Penn State University, Hershey, PA
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
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10
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Pollán M, Casla-Barrio S, Alfaro J, Esteban C, Segui-Palmer MA, Lucia A, Martín M. Exercise and cancer: a position statement from the Spanish Society of Medical Oncology. Clin Transl Oncol 2020; 22:1710-1729. [PMID: 32052383 PMCID: PMC7423809 DOI: 10.1007/s12094-020-02312-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 01/27/2020] [Indexed: 12/16/2022]
Abstract
Due to improvements in the number of cancer survivors and survival time, there is a growing interest in healthy behaviors, such as physical activity (PA), and their potential impact on cancer- and non-cancer-related morbidity in individuals with cancer. Commissioned by the Spanish Society of Medical Oncology (SEOM), in this review, we sought to distill the most recent evidence on this topic, focusing on the mechanisms that underpin the effects of PA on cancer, the role of PA in cancer prevention and in the prognosis of cancer and practical recommendations for clinicians regarding PA counseling. Despite the available information, the introduction of exercise programs into the global management of cancer patients remains a challenge with several areas of uncertainty. Among others, the most effective behavioral interventions to achieve long-term changes in a patient’s lifestyle and the optimal intensity and duration of PA should be defined with more precision in future studies.
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Affiliation(s)
- M Pollán
- Cancer and Environmental Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - S Casla-Barrio
- Exercise-Oncology Unit, Spanish Cancer Association, Madrid, Spain.,GEICAM (Spanish Breast Cancer Group), Madrid, Spain
| | - J Alfaro
- Medical Oncology, Hospital de Terrassa, Barcelona, Spain
| | - C Esteban
- Medical Oncology, Hospital Virgen de la Salud, Toledo, Spain
| | - M A Segui-Palmer
- Medical Oncology, Parc Taulí Hospital Universitari, Sabadell, Spain
| | - A Lucia
- Faculty of Sport Sciences, Universidad Europea de Madrid, Calle Tajo, s/n, 28670, Villaviciosa de Odón, Madrid, Spain. .,Instituto de Investigación Hospital 12 de Octubre and CIBER de Envejecimiento Saludable y Fragilidad (CIBERFES), Madrid, Spain.
| | - M Martín
- GEICAM (Spanish Breast Cancer Group), Madrid, Spain. .,Instituto de Investigacion Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain. .,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain. .,Medical Oncology Service, Hospital General Universitario Gregorio Marañón, Calle Dr. Esquerdo 46, 28007, Madrid, Spain.
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11
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Benke IN, Leitzmann MF, Behrens G, Schmid D. Physical activity in relation to risk of prostate cancer: a systematic review and meta-analysis. Ann Oncol 2019; 29:1154-1179. [PMID: 29788165 DOI: 10.1093/annonc/mdy073] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background Prostate cancer (PCa) is one of the most common cancers among men, yet little is known about its modifiable risk and protective factors. This study aims to quantitatively summarize observational studies relating physical activity (PA) to PCa incidence and mortality. Materials and methods Published articles pertaining to PA and PCa incidence and mortality were retrieved in July 2017 using the Medline and EMBASE databases. The literature review yielded 48 cohort studies and 24 case-control studies with a total of 151 748 PCa cases. The mean age of the study participants at baseline was 61 years. Results In random-effects models, comparing the highest versus the lowest level of overall PA showed a summary relative risk (RR) estimate for total PCa incidence close to the null [RR = 0.99, 95% confidence interval (CI) = 0.94-1.04]. The corresponding RRs for advanced and non-advanced PCa were 0.92 (95% CI = 0.80-1.06) and 0.95 (95% CI = 0.85-1.07), respectively. We noted a statistically significant inverse association between long-term occupational activity and total PCa (RR = 0.83, 95% CI = 0.71-0.98, n studies = 13), although that finding became statistically non-significant when individual studies were removed from the analysis. When evaluated by cancer subtype, an inverse association with long-term occupational activity was noted for non-advanced/non-aggressive PCa (RR = 0.51, 95% CI = 0.37-0.71, n studies = 2) and regular recreational activity was inversely related to advanced/aggressive PCa (RR = 0.75, 95% CI = 0.60-0.95, n studies = 2), although these observations are based on a low number of studies. Moreover, PA after diagnosis was related to reduced risk of PCa mortality among survivors of PCa (summary RR based on four studies = 0.69, 95% CI = 0.55-0.85). Conclusions Whether PA protects against PCa remains elusive. Further investigation taking into account the complex clinical and pathologic nature of PCa is needed to clarify the PA and PCa incidence relation. Moreover, future studies are needed to confirm whether PA after diagnosis reduces risk of PCa mortality.
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Affiliation(s)
- I N Benke
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - M F Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - G Behrens
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - D Schmid
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
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12
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An Executive Summary of Reports From an International Multidisciplinary Roundtable on Exercise and Cancer: Evidence, Guidelines, and Implementation. REHABILITATION ONCOLOGY 2019. [DOI: 10.1097/01.reo.0000000000000186] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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13
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Lee DH, Fung TT, Tabung FK, Colditz GA, Ghobrial IM, Rosner BA, Giovannucci EL, Birmann BM. Dietary Pattern and Risk of Multiple Myeloma in Two Large Prospective US Cohort Studies. JNCI Cancer Spectr 2019; 3:pkz025. [PMID: 31149654 PMCID: PMC6532330 DOI: 10.1093/jncics/pkz025] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 03/04/2019] [Accepted: 03/22/2019] [Indexed: 12/16/2022] Open
Abstract
Background The limited data on specific dietary components and risk of multiple myeloma (MM) show no consistent association. Studies have not examined the association of dietary pattern with MM risk. Methods In prospective cohorts of 69 751 women (Nurses’ Health Study, 1984–2014) and 47 232 men (Health Professionals Follow-up Study, 1986–2014), we examined the association between dietary pattern and risk of MM using Cox proportional hazard models. Diet was assessed repeatedly every 4 years with food frequency questionnaires and was used to calculate dietary patterns including the Alternate Healthy Eating Index-2010, Alternate Mediterranean Diet, Dietary Approaches to Stop Hypertension, Prudent and Western patterns, the empirical dietary inflammatory pattern (EDIP), and empirical dietary indices for insulin resistance (EDIR) and hyperinsulinemia (EDIH). Results During 2 792 257 person-years of follow-up, we identified 478 incident MM cases (215 women, 263 men). In men, high EDIP was statistically significantly associated with a 16% increase in MM risk (hazard ratio [HR] = 1.16, 95% confidence interval [CI] = 1.02 to 1.32 per 1-SD increase). Moreover, EDIR and EDIH had a suggestive positive association (EDIR: HR = 1.09, 95% CI = 0.96 to 1.24; and EDIH: HR = 1.11, 95% CI = 0.97 to 1.28 per 1-SD increase). We observed no other associations with MM risk in men and no associations for any dietary pattern with MM risk in women. Conclusions We present the first evidence for a role of diets with higher inflammatory or insulinemic potential in MM development. Further studies are warranted to explore these associations in other populations, including the apparent restriction to men.
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Affiliation(s)
- Dong Hoon Lee
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Teresa T Fung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Nutrition, Simmons University, Boston, MA
| | - Fred K Tabung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH
| | - Graham A Colditz
- Department of Public Health Sciences, Washington University School of Medicine, St. Louis, MO
| | - Irene M Ghobrial
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Bernard A Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Edward L Giovannucci
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Brenda M Birmann
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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14
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Psaltopoulou T, Sergentanis TN, Ntanasis-Stathopoulos I, Tzanninis IG, Riza E, Dimopoulos MA. Anthropometric characteristics, physical activity and risk of hematological malignancies: A systematic review and meta-analysis of cohort studies. Int J Cancer 2019; 145:347-359. [PMID: 30614529 DOI: 10.1002/ijc.32109] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 12/02/2018] [Accepted: 12/19/2018] [Indexed: 12/20/2022]
Abstract
Overweight/obesity, adult attained height and physical activity are possible risk factors for hematological malignancies. This meta-analysis aims to evaluate the associations between these factors and hematological cancer risk in adults. Eligible cohort studies were sought in PubMed up to May 31, 2016; overall, 44 studies were included in the present analyses. Pooled relative risk estimates were calculated using random-effects models; separate analyses were conducted for non-Hodgkin lymphoma (NHL) and subtypes (diffuse large B-cell lymphoma, DLBCL; follicular cell lymphoma; small lymphocytic lymphoma/chronic lymphocytic leukemia, SLL/CLL), Hodgkin lymphoma (HL), multiple myeloma (MM), leukemia and subtypes (acute lymphoblastic leukemia, acute myeloid leukemia, AML). Obesity was associated with increased risk of NHL, HL, MM, leukemia overall and AML in both sexes, as well as with higher DLBCL risk in women; the dose-response meta-regression analysis confirmed these associations. Less pronounced effects were observed regarding overweight, as it was associated with increased MM risk in both sexes, NHL risk in males, DLBCL and overall leukemia risk in females. Taller men presented with significantly higher risk of NHL and taller women were affected by higher risk of NHL, DLBCL, FL, CLL/SLL, MM, leukemia and AML. On the other hand, physical activity and abdominal fatness were not associated with the risk of hematological malignancies. In conclusion, this meta-analysis highlights the pivotal role of anthropometric measures in shaping the risk of hematological malignancies in adults. Additional, well-designed studies stemming from all the continents are needed for the further substantiation and generalization of the results.
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Affiliation(s)
- Theodora Psaltopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodoros N Sergentanis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Ntanasis-Stathopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis-Georgios Tzanninis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Elena Riza
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Meletios A Dimopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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15
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Golubović I, Marjanović G, Radojković D, Sokolović D, Karanikolić A, Radojković M, Pavlović M. FOLLICULAR LYMPHOMA INCIDENCE AND MORTALITY IN RELATION TO OVERWEIGHT, OBESI TY AND PHYSICAL ACTIVITY: A META - ANALYSIS. ACTA MEDICA MEDIANAE 2018. [DOI: 10.5633/amm.2018.0411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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16
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Etter JL, Cannioto R, Soh KT, Alquassim E, Almohanna H, Dunbar Z, Joseph JM, Balderman S, Hernandez-Ilizaliturri F, Moysich KB. Lifetime physical inactivity is associated with increased risk for Hodgkin and non-Hodgkin lymphoma: A case-control study. Leuk Res 2018; 69:7-11. [PMID: 29609041 DOI: 10.1016/j.leukres.2018.03.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 03/23/2018] [Accepted: 03/26/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Although physical activity is a well-established risk factor for several cancer types, studies evaluating its association with lymphoma have yielded inconclusive results. In such cases where physical activity is not clearly associated with cancer risk in a dose-dependent manner, investigators have begun examining physical inactivity as an independent exposure of interest. METHODS Associations of self-reported, lifetime physical inactivity with risk of developing Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) were evaluated in a hospital-based case control study using data from the Patient Epidemiology Data System at Roswell Park Comprehensive Cancer Center. Participants included 87 patients with HL and 236 patients with NHL as well as 348 and 952 cancer-free controls, respectively. Multivariable-adjusted logistic regression models were fit to calculate odds ratios (OR) and 95% confidence intervals (CI) estimating the association between physical inactivity and lymphoma risk. RESULTS We observed significant, positive associations between lifetime recreational physical inactivity and risk of both HL (OR = 1.90, 95% CI: 1.15-3.15) and NHL (OR = 1.35, 95% CI: 1.01-1.82). CONCLUSIONS The current analysis provides evidence for a positive association between physical inactivity and risk of both HL and NHL. These results add to a growing body of research suggesting that lifetime physical inactivity may be an important independent, modifiable behavioral risk factor for cancer.
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Affiliation(s)
- John Lewis Etter
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Rikki Cannioto
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Kah Teong Soh
- Department of Flow and Image Cytometry, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Emad Alquassim
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Hani Almohanna
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Zachary Dunbar
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Janine M Joseph
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Sophia Balderman
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | | | - Kirsten B Moysich
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States.
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17
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Body mass index throughout adulthood, physical activity, and risk of multiple myeloma: a prospective analysis in three large cohorts. Br J Cancer 2018. [PMID: 29527008 PMCID: PMC5931105 DOI: 10.1038/s41416-018-0010-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background Obesity is the only known modifiable multiple myeloma (MM) risk factor. However, the influence of obesity in earlier or later adulthood and the role of other energy balance correlates in MM development are unclear. Methods We leveraged repeatedly updated data from the Nurses’ Health Study, Health Professionals Follow-up Study, and Women’s Health Study cohorts to further explore energy balance measures in MM etiology. Exposures derived from questionnaires included young adult body mass index (BMI), cumulative average BMI, BMI change since young adulthood, and cumulative average physical activity and walking. We assessed MM risk related to those variables with Cox proportional hazard models. Results We observed 575 incident MM cases in over five million person-years of follow-up across the cohorts. In pooled analyses, MM risk increased 17% per 5 kg/m2 increase in cumulative average BMI (95% confidence interval (CI): 1.05, 1.29) and 28% per 5 kg/m2 increase in young adult BMI (CI: 1.12, 1.47); adjustment for BMI change since young adulthood did not affect either association. BMI change since young adulthood and cumulative average physical activity and walking were not significantly associated with MM risk. Conclusions These findings suggest that a high BMI in early and later adulthood are risk factors for MM.
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18
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Boyle T, Connors JM, Gascoyne RD, Berry BR, Sehn LH, Bashash M, Spinelli JJ. Physical activity, obesity and survival in diffuse large B-cell and follicular lymphoma cases. Br J Haematol 2017; 178:442-447. [DOI: 10.1111/bjh.14702] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 02/16/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Terry Boyle
- School of Public Health; Curtin University; Perth WA Australia
- Cancer Control Research; British Columbia Cancer Agency; Vancouver BC Canada
| | - Joseph M. Connors
- Centre for Lymphoid Cancer; British Columbia Cancer Agency; Vancouver BC Canada
| | - Randy D. Gascoyne
- Centre for Lymphoid Cancer; British Columbia Cancer Agency; Vancouver BC Canada
| | - Brian R. Berry
- Department of Pathology and Laboratory Medicine; Royal Jubilee Hospital; Victoria BC Canada
| | - Laurie H. Sehn
- Centre for Lymphoid Cancer; British Columbia Cancer Agency; Vancouver BC Canada
| | - Morteza Bashash
- Dalla Lana School of Public Health; University of Toronto; Toronto ON Canada
| | - John J. Spinelli
- Population Oncology; British Columbia Cancer Agency; Vancouver BC Canada
- School of Population and Public Health; University of British Columbia; Vancouver BC Canada
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19
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Robsahm TE, Falk RS, Heir T, Sandvik L, Vos L, Erikssen J, Tretli S. Cardiorespiratory fitness and risk of site-specific cancers: a long-term prospective cohort study. Cancer Med 2017; 6:865-873. [PMID: 28317282 PMCID: PMC5387170 DOI: 10.1002/cam4.1043] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 01/23/2017] [Accepted: 01/23/2017] [Indexed: 12/13/2022] Open
Abstract
Based on self‐reported physical activity, there is epidemiologic evidence for a beneficial relation between physical activity and colon cancer in men, but findings for other cancers are inconclusive. Measured cardiorespiratory fitness (CRF) can provide knowledge about the cancer‐preventive value of physical activity. We aimed to assess relationships between CRF and risk of site‐specific cancers. A cohort of 1997 healthy Norwegian men, aged 40–59 years at inclusion in 1972–1975, was followed for cancer throughout 2012 using data from the Cancer Registry of Norway. CRF was measured by a maximal exercise bicycle test at inclusion. Relationships between CRF and site‐specific cancers were estimated using Cox regression, adjusted for age, body mass index, and smoking. During follow‐up, 898 cancer cases were diagnosed in 758 men. When comparing men in CRF tertile 1 with men in tertiles 2 and 3, respectively, we found decreased risk of proximal colon cancer in tertile 2 (HR: 0.30, 95% CI: 0.13–0.73) and decreased risk of cancers of lung (0.39 95% CI: 0.22–0.66), pancreas (0.32 95% CI: 0.10–1.00), and bladder (HR: 0.40 95% CI: 0.21–0.74) in tertile 3. Furthermore, a significant trend for lower risk by increasing CRF tertile was found for cancers of proximal colon, lung, and bladder (P‐value for trend <0.05). For other cancer sites, no significant association was found. Our results indicate that high midlife CRF may have cancer‐preventive value.
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Affiliation(s)
- Trude E Robsahm
- Department of Research, Cancer Registry of Norway, PB 5313 Majorstuen, Oslo, 0304, Norway
| | - Ragnhild S Falk
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, PB 4950 Nydalen, Oslo, 0424, Norway
| | - Trond Heir
- Oslo Ischemia Study, Oslo University Hospital, Oslo, Norway
| | - Leiv Sandvik
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, PB 4950 Nydalen, Oslo, 0424, Norway
| | - Linda Vos
- Department of Research, Cancer Registry of Norway, PB 5313 Majorstuen, Oslo, 0304, Norway
| | - Jan Erikssen
- Oslo Ischemia Study, Oslo University Hospital, Oslo, Norway
| | - Steinar Tretli
- Department of Research, Cancer Registry of Norway, PB 5313 Majorstuen, Oslo, 0304, Norway.,Department of Public Health and General Practice, Norwegian University of Science and Technology, PB 8905, Trondheim, 7491, Norway
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20
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Efficacy of Exercise Interventions in Patients with Acute Leukemia: A Meta-Analysis. PLoS One 2016; 11:e0159966. [PMID: 27463234 PMCID: PMC4962985 DOI: 10.1371/journal.pone.0159966] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 07/09/2016] [Indexed: 02/06/2023] Open
Abstract
Background Decreased physical performance and impaired physiological and psychological fitness have been reported in patients with acute leukemia (AL). We performed a meta-analysis to assess the efficacy of exercise in patients with AL. Methods In this meta-analysis, the electronic databases MEDLINE, Embase, Cochrane, Web of Science, SPORTDiscus, CINAHL and PEDro were searched through November 2015. Three authors participated in the study selection, data extraction and quality assessment. The instrument used for quality assessment was derived from the Cochrane Handbook for Systematic Reviews of Interventions. Analyses were performed according to the recommendations of The Cochrane Collaboration using Review Manager 5.3. Results Nine trials (8 randomized controlled trials and 1 quasi-experimental design trial) with 314 AL participants were included in this meta-analysis. The pooled standardized mean differences between the exercise and control groups were 0.45 (95% confidence interval (CI): 0.09 to 0.80, P value = 0.01, P for heterogeneity = 0.23, I2 = 28%) for cardiorespiratory fitness and 0.67 (95% CI: 0.28 to 1.06, P value = 0.0007, P for heterogeneity = 0.14, I2 = 43%) for muscle strength. Based on the data for fatigue, anxiety, and depression, there were no significant differences in these parameters between the exercise and control groups. Conclusions Exercise has beneficial effects on cardiorespiratory fitness, muscle strength and functional mobility; however, no significant improvements in fatigue, anxiety, depression or quality of life were observed. Further large-scale randomized trials are needed to assess the safety, feasibility and efficacy of exercise programs for AL patients.
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21
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Hayes BD, Brady L, Pollak M, Finn SP. Exercise and Prostate Cancer: Evidence and Proposed Mechanisms for Disease Modification. Cancer Epidemiol Biomarkers Prev 2016; 25:1281-8. [PMID: 27389872 DOI: 10.1158/1055-9965.epi-16-0223] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 06/27/2016] [Indexed: 11/16/2022] Open
Abstract
Exercise has many potential benefits in relation to cancer. Apart from primary prevention, these include improvement of nonspecific cancer-related symptoms, amelioration of symptoms and cardiovascular risk factors related to cancer treatment, and improvements in various quality-of-life-related factors. Increasing evidence also points toward improved cancer-free and overall survival in cancer patients who undertake regular exercise, findings which should encourage further research in this area. Obesity is known to be associated with a proinflammatory, prothrombotic humoral milieu, which may promote aggressiveness in prostate cancer through interactions with NK-cell-mediated killing of circulating tumor cells, through platelet-circulating tumor cell interactions, and through alterations in adipokine and myokine profile among others. Physical activity reduces levels of systemic inflammatory mediators and so exercise may represent an accessible and cost-effective means of ameliorating the proinflammatory effects of obesity in cancer patients. This review outlines the evidence for the benefits of exercise in these patients, focusing on prostate cancer, and delineates current theories of the underlying biological mechanisms. Cancer Epidemiol Biomarkers Prev; 25(9); 1281-8. ©2016 AACR.
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Affiliation(s)
- Brian D Hayes
- Department of Histopathology, Cork University Hospital, Wilton, Cork, Ireland. Department of Histopathology & Morbid Anatomy, Trinity College, Dublin, Ireland.
| | - Lauren Brady
- Department of Histopathology & Morbid Anatomy, Trinity College, Dublin, Ireland
| | - Michael Pollak
- Departments of Medicine and Oncology, McGill University, Montreal, Quebec, Canada
| | - Stephen P Finn
- Department of Histopathology & Morbid Anatomy, Trinity College, Dublin, Ireland. Department of Histopathology, St. James's Hospital, Dublin, Ireland
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22
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Moore SC, Lee IM, Weiderpass E, Campbell PT, Sampson JN, Kitahara CM, Keadle SK, Arem H, de Gonzalez AB, Hartge P, Adami HO, Blair CK, Borch KB, Boyd E, Check DP, Fournier A, Freedman ND, Gunter M, Johannson M, Khaw KT, Linet MS, Orsini N, Park Y, Riboli E, Robien K, Schairer C, Sesso H, Spriggs M, Van Dusen R, Wolk A, Matthews CE, Patel AV. Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults. JAMA Intern Med 2016; 176:816-25. [PMID: 27183032 PMCID: PMC5812009 DOI: 10.1001/jamainternmed.2016.1548] [Citation(s) in RCA: 784] [Impact Index Per Article: 98.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
IMPORTANCE Leisure-time physical activity has been associated with lower risk of heart-disease and all-cause mortality, but its association with risk of cancer is not well understood. OBJECTIVE To determine the association of leisure-time physical activity with incidence of common types of cancer and whether associations vary by body size and/or smoking. DESIGN, SETTING, AND PARTICIPANTS We pooled data from 12 prospective US and European cohorts with self-reported physical activity (baseline, 1987-2004). We used multivariable Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals for associations of leisure-time physical activity with incidence of 26 types of cancer. Leisure-time physical activity levels were modeled as cohort-specific percentiles on a continuous basis and cohort-specific results were synthesized by random-effects meta-analysis. Hazard ratios for high vs low levels of activity are based on a comparison of risk at the 90th vs 10th percentiles of activity. The data analysis was performed from January 1, 2014, to June 1, 2015. EXPOSURES Leisure-time physical activity of a moderate to vigorous intensity. MAIN OUTCOMES AND MEASURES Incident cancer during follow-up. RESULTS A total of 1.44 million participants (median [range] age, 59 [19-98] years; 57% female) and 186 932 cancers were included. High vs low levels of leisure-time physical activity were associated with lower risks of 13 cancers: esophageal adenocarcinoma (HR, 0.58; 95% CI, 0.37-0.89), liver (HR, 0.73; 95% CI, 0.55-0.98), lung (HR, 0.74; 95% CI, 0.71-0.77), kidney (HR, 0.77; 95% CI, 0.70-0.85), gastric cardia (HR, 0.78; 95% CI, 0.64-0.95), endometrial (HR, 0.79; 95% CI, 0.68-0.92), myeloid leukemia (HR, 0.80; 95% CI, 0.70-0.92), myeloma (HR, 0.83; 95% CI, 0.72-0.95), colon (HR, 0.84; 95% CI, 0.77-0.91), head and neck (HR, 0.85; 95% CI, 0.78-0.93), rectal (HR, 0.87; 95% CI, 0.80-0.95), bladder (HR, 0.87; 95% CI, 0.82-0.92), and breast (HR, 0.90; 95% CI, 0.87-0.93). Body mass index adjustment modestly attenuated associations for several cancers, but 10 of 13 inverse associations remained statistically significant after this adjustment. Leisure-time physical activity was associated with higher risks of malignant melanoma (HR, 1.27; 95% CI, 1.16-1.40) and prostate cancer (HR, 1.05; 95% CI, 1.03-1.08). Associations were generally similar between overweight/obese and normal-weight individuals. Smoking status modified the association for lung cancer but not other smoking-related cancers. CONCLUSIONS AND RELEVANCE Leisure-time physical activity was associated with lower risks of many cancer types. Health care professionals counseling inactive adults should emphasize that most of these associations were evident regardless of body size or smoking history, supporting broad generalizability of findings.
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Affiliation(s)
- Steven C. Moore
- Division of Cancer Epidemiology and Genetics, NCI, Bethesda, MD
| | - I-Min Lee
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Elisabete Weiderpass
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
- Department of Research, Cancer Registry of Norway, Institute of Population Based Cancer Research, Oslo, Norway
| | | | | | | | - Sarah K. Keadle
- Division of Cancer Epidemiology and Genetics, NCI, Bethesda, MD
| | - Hannah Arem
- Division of Cancer Epidemiology and Genetics, NCI, Bethesda, MD
| | | | - Patricia Hartge
- Division of Cancer Epidemiology and Genetics, NCI, Bethesda, MD
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Harvard Chan School of Public Health, Boston, MA
| | - Cindy K. Blair
- Division of Epidemiology, Biostatistics, and Preventive Medicine, University of New Mexico, Albuquerque, NM
| | - Kristin B. Borch
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Eric Boyd
- Information Management Services, Inc., Rockville, MD
| | - David P. Check
- Division of Cancer Epidemiology and Genetics, NCI, Bethesda, MD
| | - Agnès Fournier
- Inserm, CESP Centre for Research in Epidemiology and Population Health, U1018, Lifestyle, genes and health: integrative trans-generational epidemiology, F-94805, Villejuif, France
- Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | | | - Marc Gunter
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom
| | - Mattias Johannson
- Genetic Epidemiology Group, International Agency for Research on Cancer (IARC), Lyon, France
- Department of Biobank Research, Umeå University, Umeå, Sweden
| | - Kay-Tee Khaw
- Cambridge Institute of Public Health, University of Cambridge, United Kingdom
| | - Martha S. Linet
- Division of Cancer Epidemiology and Genetics, NCI, Bethesda, MD
| | - Nicola Orsini
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Yikyung Park
- Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom
| | - Kim Robien
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC
| | | | - Howard Sesso
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | | | - Roy Van Dusen
- Information Management Services, Inc., Rockville, MD
| | - Alicja Wolk
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Alpa V. Patel
- Epidemiology Research Program, American Cancer Society, Atlanta, GA
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23
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Boyle T, Gallagher RP, Gascoyne RD, Connors JM, Le ND, Spinelli JJ. Lifetime physical activity and the risk of non-Hodgkin lymphoma. Cancer Epidemiol Biomarkers Prev 2016; 24:873-7. [PMID: 25934832 DOI: 10.1158/1055-9965.epi-14-1303] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Research regarding the association between physical activity and the risk of non-Hodgkin lymphoma (NHL) is limited and inconsistent, and few studies have investigated whether the intensity and timing of physical activity influence the association. A case-control study of NHL was conducted in British Columbia, Canada, in 2000 to 2004. Data were collected on various NHL risk factors, including moderate-intensity and vigorous-intensity physical activity performed over the lifetime. Logistic regression was used to estimate the association between physical activity and the risk of NHL. This analysis included 818 controls and 749 cases. Lifetime vigorous-intensity physical activity was inversely associated with NHL risk. Participants in the second, third, and fourth quartiles of lifetime vigorous-intensity physical activity had an approximately 25% to 30% lower risk of NHL than those in the lowest quartile [adjusted odds ratios, 0.69 (95% confidence interval [CI], 0.52-0.93); 0.68 (95% CI, 0.50-0.92); and 0.75 (95% CI, 0.55-1.01), respectively]. No consistent associations were observed for total or moderate-intensity physical activity. There were no apparent age periods in which physical activity appeared to confer a greater risk reduction. In this study, we found that lifetime vigorous-intensity physical activity was associated with a significantly reduced risk of NHL. Given this finding, more research on physical activity intensity and timing in relation to NHL risk is warranted.
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Affiliation(s)
- Terry Boyle
- Cancer Control Research, British Columbia Cancer Agency, Vancouver, British Columbia, Canada. School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada. Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia.
| | - Richard P Gallagher
- Cancer Control Research, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Randy D Gascoyne
- Centre for Lymphoid Cancer, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Joseph M Connors
- Centre for Lymphoid Cancer, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Nhu D Le
- Cancer Control Research, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - John J Spinelli
- Cancer Control Research, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
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Abstract
OBJECTIVES Multiple myeloma is the second most common haematological cancer. A growing body of literature is emerging that investigates the role physical activity plays in all stages of multiple myeloma (prevention and survivorship) and to date no attempt has been made to collate and understand this literature. Therefore, this scoping review aims to (1) outline what is already known about physical activity in all stages of multiple myeloma (2) map the literature on physical activity and multiple myeloma and (3) identify future directions for research. DESIGN Scoping Review. DATA SOURCES Searches were carried out in May 2015. Searchers were conducted in PubMed, Web of Science, SPORTdiscus and MEDLINE. ELIGIBILITY CRITERIA FOR SELECTING STUDIES To be included studies had to report original data, investigate physical activity per se or physical activity correlates and multiple myeloma or smouldering multiple myeloma. RESULTS A total of 19 papers received full screening, 5 of these papers were excluded. This review identified three journal articles relating to the role of physical activity in the prevention of multiple myeloma, nine papers were identified in the treatment of multiple myeloma and two on smouldering multiple myeloma. CONCLUSIONS The search identified that the literature surrounding multiple myeloma and physical activity is very limited. We encourage those designing new cohort studies to allow for future assessment of associations between physical activity and onset of multiple myeloma and smouldering multiple myeloma, as well as the potential role that physical activity plays in the progression from smouldering multiple myeloma to multiple myeloma. Second, we encourage the design and investigation of gender and treatment-specific physical activity interventions in patients with multiple myeloma. Finally, we highlight the need for more randomised controlled trials to evaluate the impact of different types, frequencies and intensities of physical activity on various health parameters in multiple myeloma survivors.
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Affiliation(s)
- Lee Smith
- Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London, London, UK
| | - Orla McCourt
- Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London, London, UK
| | - Malgorzata Henrich
- Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London, London, UK
| | - Bruce Paton
- Institute of Sport Exercise and Health, University College London, London, UK
| | - Kwee Yong
- Research Department of Haematology, Cancer Institute, University College London, London,UK
| | - Jane Wardle
- Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London, London, UK
| | - Abigail Fisher
- Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London, London, UK
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25
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Niedermaier T, Behrens G, Schmid D, Schlecht I, Fischer B, Leitzmann MF. Body mass index, physical activity, and risk of adult meningioma and glioma: A meta-analysis. Neurology 2015; 85:1342-50. [PMID: 26377253 DOI: 10.1212/wnl.0000000000002020] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 06/18/2015] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Whether adiposity and lack of physical activity affect the risk for developing meningioma and glioma is poorly understood. Our objective was to characterize these associations in detail. METHODS We conducted a systematic review and meta-analysis of adiposity and physical activity in relation to meningioma and glioma using cohort and case-control studies published through February 2015. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS We identified 12 eligible studies of body mass index (BMI) and 6 studies of physical activity, comprising up to 2,982 meningioma cases and 3,057 glioma cases. Using normal weight as the reference group, overweight (summary relative risk [RR] = 1.21, 95% confidence interval [CI] = 1.01-1.43) and obesity (RR = 1.54, 95% CI = 1.32-1.79) were associated with increased risk of meningioma. In contrast, overweight (RR = 1.06, 95% CI = 0.94-1.20) and obesity (RR = 1.11, 95% CI = 0.98-1.27) were unrelated to glioma. Similarly, dose-response meta-analyses revealed a statistically significant positive association of BMI with meningioma, but not glioma. High vs low physical activity levels showed a modest inverse relation to meningioma (RR = 0.73, 95% CI = 0.61-0.88) and a weak inverse association with glioma (RR = 0.86, 95% CI = 0.76-0.97). Relations persisted when the data were restricted to prospective studies, except for the association between physical activity and glioma, which was rendered statistically nonsignificant (RR = 0.91, 95% CI = 0.77-1.07). CONCLUSIONS Adiposity is related to enhanced risk for meningioma but is unassociated with risk for glioma. Based on a limited body of evidence, physical activity is related to decreased risk of meningioma but shows little association with risk of glioma.
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Affiliation(s)
- Tobias Niedermaier
- From the Department of Epidemiology and Preventive Medicine, University of Regensburg, Germany
| | - Gundula Behrens
- From the Department of Epidemiology and Preventive Medicine, University of Regensburg, Germany.
| | - Daniela Schmid
- From the Department of Epidemiology and Preventive Medicine, University of Regensburg, Germany
| | - Inga Schlecht
- From the Department of Epidemiology and Preventive Medicine, University of Regensburg, Germany
| | - Beate Fischer
- From the Department of Epidemiology and Preventive Medicine, University of Regensburg, Germany
| | - Michael F Leitzmann
- From the Department of Epidemiology and Preventive Medicine, University of Regensburg, Germany
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26
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Sergentanis TN, Zagouri F, Tsilimidos G, Tsagianni A, Tseliou M, Dimopoulos MA, Psaltopoulou T. Risk Factors for Multiple Myeloma: A Systematic Review of Meta-Analyses. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2015; 15:563-77.e1-3. [PMID: 26294217 DOI: 10.1016/j.clml.2015.06.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 06/12/2015] [Indexed: 11/30/2022]
Abstract
The epidemiology of multiple myeloma (MM) is an increasingly investigated field, with many controversies. This systematic review aims to synthesize meta-analyses examining risk factors for MM so as to provide a comprehensive, parsimonious summary of the current evidence. Eligible meta-analyses were sought in PubMed adopting a predefined algorithm, without any restriction of publication language; end-of-search date was October 10, 2014. The selection of eligible studies and data extraction were performed by working in pairs, independently and blindly to each other; in case of disagreement, consensus with the whole team was reached. Among the 22 ultimately included meta-analyses, 9 examined occupational factors, 4 assessed aspects of lifestyle (smoking, alcohol, body mass index), 5 evaluated the presence of other diseases, and 4 addressed genetic factors as potential risk factors of MM. A vast compendium of significant associations arose, including farming, occupation as a firefighter, occupation as a hairdresser, exposures to chemicals or pesticides, overweight and obesity, patterns of alcohol intake, pernicious anemia, ankylosing spondylitis, gene promoter methylation, and polymorphisms. In conclusion, MM is a multifactorial disease, encompassing a wide variety of risk factors that span numerous life aspects. Further accumulation of evidence through meta-analyses is anticipated in this rapidly growing field.
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Affiliation(s)
- Theodoros N Sergentanis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Flora Zagouri
- Department of Clinical Therapeutics, "Alexandra" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Gerasimos Tsilimidos
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Tsagianni
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Melina Tseliou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Meletios A Dimopoulos
- Department of Clinical Therapeutics, "Alexandra" Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
| | - Theodora Psaltopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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27
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Behrens G, Jochem C, Schmid D, Keimling M, Ricci C, Leitzmann MF. Physical activity and risk of pancreatic cancer: a systematic review and meta-analysis. Eur J Epidemiol 2015; 30:279-98. [DOI: 10.1007/s10654-015-0014-9] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 03/03/2015] [Indexed: 01/09/2023]
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28
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Courneya KS, Friedenreich CM, Franco-Villalobos C, Crawford JJ, Chua N, Basi S, Norris MK, Reiman T. Effects of supervised exercise on progression-free survival in lymphoma patients: an exploratory follow-up of the HELP Trial. Cancer Causes Control 2014; 26:269-276. [PMID: 25491935 DOI: 10.1007/s10552-014-0508-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 12/03/2014] [Indexed: 12/25/2022]
Abstract
PURPOSE Few randomized controlled trials in exercise oncology have examined survival outcomes. Here, we report an exploratory follow-up of progression-free survival (PFS) from the Healthy Exercise for Lymphoma Patients (HELP) Trial. METHODS The HELP Trial randomized 122 lymphoma patients between 2005 and 2008 to either control (n = 62) or 12 weeks of supervised aerobic exercise (n = 60). PFS events were abstracted from medical records in 2013. In addition to the randomized comparison, we explored the effects of exercise adherence (<80 % vs. ≥80 %) and control group crossover (no vs. yes). RESULTS After a median follow-up of 61 months (interquartile range 36-67), the adjusted 5-year PFS was 64.8 % for the exercise group compared with 65.0 % for the control group (Hazard ratio [HR] 1.01, 95 % CI 0.51-2.01, p = 0.98). In the secondary analysis, the adjusted 5-year PFS was 59.0 % in the control group without crossover compared with 69.2 % for the control group with crossover (HR 0.68, 95 % CI 0.22-2.06, p = 0.49), 67.7 % for the exercise group with <80 % adherence (HR 0.72, 95 % CI 0.28-1.85, p = 0.50), and 68.4 % for the exercise group with ≥80 % adherence (HR 0.70, 95 % CI 0.32-1.56, p = 0.39). In a post hoc analysis combining the three groups that received supervised exercise, the adjusted 5-year PFS for the supervised exercise groups was 68.5 % compared with 59.0 % for the group that received no supervised exercise (HR 0.70, 95 % CI 0.35-1.39, p = 0.31). CONCLUSIONS This exploratory follow-up of the HELP Trial suggests that supervised aerobic exercise may be associated with improved PFS in lymphoma patients. Larger trials designed to answer this question are needed.
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Affiliation(s)
- Kerry S Courneya
- Faculty of Physical Education and Recreation, University of Alberta, E-488 Van Vliet Center, Edmonton, AB, T6G 2H9, Canada.
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB, Canada
| | | | - Jennifer J Crawford
- Faculty of Physical Education and Recreation, University of Alberta, E-488 Van Vliet Center, Edmonton, AB, T6G 2H9, Canada
| | - Neil Chua
- Department of Oncology, University of Alberta, Edmonton, AB, Canada
- Cross Cancer Institute, Edmonton, AB, Canada
| | - Sanraj Basi
- Department of Oncology, University of Alberta, Edmonton, AB, Canada
- Cross Cancer Institute, Edmonton, AB, Canada
| | - Mary K Norris
- Faculty of Physical Education and Recreation, University of Alberta, E-488 Van Vliet Center, Edmonton, AB, T6G 2H9, Canada
| | - Tony Reiman
- Department of Oncology, Saint John Regional Hospital, Saint John, NB, Canada
- Department of Biology, University of New Brunswick, Saint John, NB, Canada
- Department of Medicine, Dalhousie University, Halifax, NS, Canada
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