# Systematic Light Exposure Effects on Circadian Rhythms Entrainment, Inflammation, Neutropenic Fever and Symptom Burden among Multiple Myeloma Patients undergoing Autologous Stem Cell Transplantation

> **NIH NIH R01** · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · 2024 · $674,721

## Abstract

PROJECT SUMMARY
Multiple Myeloma (MM) patients undergoing Autologous Stem Cell Transplantation (ASCT)
experience clinically significant negative sequelae affecting disease prognosis, survival, and
quality of life. These sequelae include increase in production of pro-inflammatory cytokines,
higher occurrences of neutropenic fever and higher symptom burden (e.g., depression, pain)
which are associated with circadian rhythm disruption (CRD). CRD involves disruption in
naturally occurring 24-hour cycles of hormone secretion, temperature and activity. CRD raises
production of pro-inflammatory cytokines unfolding a cascade of negative effects that include
higher symptom burden and risk of developing neutropenic fever. CRD has been associated
with poorer prognosis and survival. Our recently completed R21 study showed that morning
circadian-effective illumination of patients' hospital rooms resulted in significantly higher
nocturnal melatonin levels, reduced depression and production of inflammatory cytokines
compared to the circadian-ineffective group (control). In the active group, an improvement in
sleep and reduction in neutropenic fever was observed. Our R21 results also showed a strong
negative relationship between melatonin levels and pro-inflammatory cytokines. Therefore, for
the proposed multi-site randomized controlled trial (RCT) we hypothesize that circadian
entrainment resulting from morning light exposure will lead to better sleep, lower levels of pro-
inflammatory cytokines and symptom burden, as well as fewer occurrences of neutropenic
fever. We will investigate if circadian-effective illumination, of patients' hospital rooms/outpatient
settings during ASCT, promotes circadian entrainment and improves sleep, and if circadian
entrainment reduces inflammation. We will also investigate whether better entrainment and
lower levels of pro-inflammatory markers are associated with fewer occurrences of neutropenic
fever and reduced symptom burden. The circadian stimulating light will be installed in the
outpatient setting/hospital rooms since transplants are performed in both settings. A unique
advantage of our intervention is that it does not require any patient effort because the circadian-
active light is delivered throughout the entire room.
The project will determine if: 1) circadian-effective light compared to circadian-ineffective light,
delivered during ASCT results in circadian rhythm entrainment; 2) circadian entrainment
reduces pro-inflammation cytokines and mediates the effects of circadian-effective light on the
cytokines; and 3) reduced levels of inflammatory cytokines are associated with reduced
occurrence of neutropenic fever and lower symptom burden in patients.

## Key facts

- **NIH application ID:** 10876916
- **Project number:** 5R01CA260961-03
- **Recipient organization:** ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
- **Principal Investigator:** Mariana Gross Figueiro
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $674,721
- **Award type:** 5
- **Project period:** 2022-07-22 → 2027-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10876916

## Citation

> US National Institutes of Health, RePORTER application 10876916, Systematic Light Exposure Effects on Circadian Rhythms Entrainment, Inflammation, Neutropenic Fever and Symptom Burden among Multiple Myeloma Patients undergoing Autologous Stem Cell Transplantation (5R01CA260961-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10876916. Licensed CC0.

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