Physiological prehabilitation for patients undergoing cellular therapy in multiple myeloma and lymphoma: a systematic review.
Janelle Marie Susa Barredo, Chi Ching Lim, Yijun Loy et al.
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In 30 seconds
This systematic review examined exercise-based physiological prehabilitation in adults with multiple myeloma or lymphoma before cellular or immune-based therapy. It included 12 studies involving 501 participants: three pilot randomised controlled trials and nine quasi-experimental studies. Ten studies assessed prehabilitation before transplantation and two before CAR-T therapy; none addressed BiTE therapy. Physical function and lower-limb performance findings were generally favourable, while results for handgrip strength, quality of life, and fatigue were mixed. Heterogeneous methods and predominantly uncontrolled designs limit confidence in the findings.
Key findings
- The review included 12 studies (501 participants): three pilot RCTs and nine quasi-experimental studies.
- Ten studies evaluated transplantation and two CAR-T therapy; none evaluated BiTE therapy.
- Physical function and lower-limb performance findings were generally favourable, whereas handgrip strength, quality of life, and fatigue findings were mixed.
- Nine programmes reported a central or protocol duration within 4-8 weeks.
Why it matters
Functional readiness may be relevant to patients facing intensive cellular or immune-based treatment, and the review suggests exercise before therapy could support physical function. However, the evidence is preliminary and does not establish consistent benefits across outcomes or treatment types. The findings highlight the need to distinguish promising functional signals from demonstrated effects on quality of life, fatigue, or recovery.
What to keep in mind
Methods were heterogeneous, and most studies were uncontrolled, limiting interpretation. Evidence was absent for BiTE therapy and included only two CAR-T studies.