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Yoga and Exercise Benefit Patients with MPNs

JUNE 02, 2017
James Radke
A couple of studies focusing on the benefits of exercise and yoga in patients with rare hematologic conditions were presented at the American Society of Clinical Oncology (ASCO) annual meeting that began today in Chicago.  

One study out of the Mayo Clinic in Phoenix, AZ assessed the effects of supportive care of patients with myeloproliferative neoplasms.1 The results indicate supportive care, such as exercise and yoga programs, can prove to be beneficial to these patients.
 
Myeloproliferative neoplasms include a variety of blood disorders (i.e., myelofibrosis, polycythemia vera, and essential thrombocytosis). Pharmacologic treatment can stabilize the patients' blood counts but they generally provide only partial symptom improvement.
 
The study was designed to evaluate the effectiveness of supportive care programs in these patients.
 
Using an online survey, 858 patients were assessed using the Myeloproliferative Neoplasm Symptom Assessment Form total symptom score (MPN-SAF TSS). Of the patients, 338 had essential thrombocytosis (ET), 188 had myelofibrosis (MF), 315 had polycythemia vera (PV), and 17 had ‘other.’
 
The most frequently used therapies were aerobic activity in 442 patients (51.5%), massage in 244 (28.4%), yoga in 220 (25.6%), nutrition in 216 (25.1%), and strength training in 204 (23.7%). 
 
The study observed that aerobic activity, massage, yoga, and strength training significantly reduced  MPN-SAF TSS scores whereas, nutritional counselling had no significant impact.  
 
Within the subgroups, yoga therapy did not statistically improve MPN-SAF TSS scores in ET and PV patients. Further, in the MF patients, no intervention was shown to significantly change MPN-SAF TSS scores although aerobic exercise was close to be statistically significant (P = .06). 

Table: Changes in MPN-SAS TSS Scores

  Overall
(N=858)
ET
(N=338)
PV
(N=315
MF
(N=188)
 
 Age (mean)
 Sex (Female %)
 MPN-SAF TSS (mean)
 
58.2 yrs
77.5%
27.1
56.0 yrs
87.2%
27.8
58.8 yrs
73.3%
26.2
61.3 yrs
68.8%
26.2

 Massage
 Yoga
 Nutrition
 Stength Training
 
P < .001
P = .02
P = .10
P < .001
P = .007
P = .35
P = .36
P = .03
P = .02
P = .14
P = .07
P = .02
P = .13
P = .34
P = .68
P = .14


A second study by the Mayo Clinic looked at 38 myeloproliferative neoplasm patients who completed a 12-week online yoga class (60 minutes / week).2

At the end of the program, 68% of patients were satisfied with online yoga and 75% felt that is was helpful for coping with disease-related symptoms. Only one adverse event was reported (irritated enlarged spleen).
 
Over the 12-week period, the study found significant improvements in total symptom burden (effect size [ES] in standard deviation units = -0.36, P = .004), anxiety (ES = -0.67, P = .002), depression (ES = -0.41, P = .049), sleep (ES = -0.58, P < .001), and fatigue (ES = -0.33, P = .04).
 
The authors of the 2 studies concluded that supportive care is associated with improved symptom burden in patients with myeloproliferative neoplasms but more studies are needed.

Reference

  1. Gowin KL, Millstine D, Kosiorek HE, et al. Supportive care and symptom burden in patients with myeloproliferative neoplasms. J Clin Oncol 2017;35: (suppl; abstr e21684).
  2. Huberty J, Eckert  R, Gowin KL, et al. Online yoga as a non-pharmacologic symptom management approach in myeloproliferative neoplasms. J Clin Oncol 2017;35: (suppl; abstr e21704).


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