1. Introduction
MM, cancer, anemia, hematologic malignancies, Multiple myeloma
DISEASE PROGRESSION, OXIDATIVE STRESS, PROLIFERATION, CANCER, HEMATOLOGIC MALIGNANCY, DISEASE, DNA DAMAGE, ANEMIA, HEMATOLOGIC MALIGNANCIES, MULTIPLE MYELOMA, REMISSION, BLOOD, OXIDATIVE STRESS
Multiple myeloma (MM) is an incurable hematologic malignancy originating from clonal plasma cell proliferation within the bone marrow, predominantly affecting older individuals. While anemia serves as a diagnostic criterion for MM, it often ameliorates upon achieving disease remission. Iron metabolism parameters have emerged as potential prognostic indicators in MM. Notably, physical exercise has been established to influence iron metabolism. This study aimed to assess alterations in serum iron, ferritin, and transferrin concentrations, as well as leukocyte gene expression, in MM patients undergoing a six-week cycle of Nordic walking training. Thirty patients divided into an exercise group (NW, n = 15, mean age 63.1 ± 8.4 years) and a control group (CG, n = 15, mean age: 63.5 ± 3.6 years) completed the study protocol. Blood samples were collected at baseline, after three and six weeks of training, and after nine weeks. Serum ferritin, transferrin, and iron concentrations were measured, along with the leukocyte expression of genes. Additionally, serum oxidative damage marker levels were determined. Following the Nordic walking training cycle, a declining trend in serum ferritin concentrations was observed. Intracellular mRNA levels of genes associated with iron metabolism were positively influenced by the training regimen, indicating the potential impact of this physical activity on gene expression and ferritin concentrations. Although positive trends were noted, extended training periods might be requisite for significant changes. To conclude, moderate-intensity exercise induces favorable shifts in the analyzed parameters among MM patients, potentially influencing disease progression. Consequently, Nordic walking training is a safe recommendation for MM patients, though sustained training beyond six weeks could be necessary for notable effects on iron metabolism factors.Multiple myeloma (MM) is a hematologic malignancy originating from plasma cells found in the bone marrow. This disease accounts for approximately 10 to 15% of all diagnosed hematologic malignancies and approximately 1–2% of all cancer cases [Iron homeostasis is of great importance in patients with MM, as they often experience anemia (approximately 75% of patients), which is one of the diagnostic criteria for this disease [Oxidative stress is one of the main factors which influences iron metabolism and the expression of genes associated with it. The level of oxidative stress and oxidative damage increases with age [Free radical-induced damage also plays a significant role in MM. Patients with MM have been shown to exhibit high levels of oxidative stress compared to healthy individuals. This is associated with decreased activity of antioxidant enzymes in these patients and increased levels of lipid peroxidation products, protein oxidation, and DNA damage [Walking with poles, also known as Nordic walking, is a safe form of physical activity recommended for both older individuals and patients with hematologic malignancies. In patients with MM in remission, it has been shown to have a beneficial effect on disease parameters [The aim of this study was to assess the impact of a six-week cycle of Nordic walking training on iron metabolism parameters and the expression of related genes in patients with MM. Additionally, this study aimed to evaluate the effects of oxidative stress by measuring the serum concentrations of products of oxidative modifications of macromolecules.