Childhood Leukemia Survivors and Metabolic Response to Exercise: A Pilot Controlled Study

Abstract

Background: Leukemia is the most common cancer in pediatrics, with many late effects such as higher risk of dyslipidemia, insulin resistance, obesity, and metabolic syndrome. The objective of this work was to investigate substrate oxidation during submaximal exercise in survivors of childhood acute leukemia. Methods: A total of 20 leukemia survivors and 20 healthy children were matched by sex, age, and Tanner stage. They all took a submaximal incremental exercise test to determine fat and carbohydrate oxidation rates. Results: Cardiorespiratory fitness was significantly lower in leukemia survivors, with lower relative VO2 peaks (p < 0.001), lower heart rate values (p = 0.02), and lower exercise power (p = 0.012), whereas rest metabolism and body mass index did not differ between the two groups. During exercise, upward of heart rate relative to VO2 peak was significantly higher (p < 0.001) in childhood leukemia survivors. We found lower carbohydrate and fat oxidation rates (p = 0.07) in leukemia survivors compared with healthy children, and also a significantly lower relative maximal fat oxidation rate (p = 0.014). Conclusion: Despite impaired physical fitness and metabolic response to exercise, childhood leukemia survivors remained sensitive to physical activity interventions, and could readily adapt to submaximal exercise intensity.

Adherence to dietary recommendations by children and adolescents during steroid therapy in acute lymphoblastic leukemia

“…Diet and exercise are one of the few modifiable behaviors that can prevent or delay the onset of obesity-related chronic diseases. Physical activity in children with ALL improves physical and metabolic performance, reduces the risk of physical impairment and improves the quality of life [21].…”

“…They perform much less physical activity than their healthy peers, both during and after therapy [6,22]. Children who have completed their treatment for leukemia should regularly perform physical activity appropriate to their cardiopulmonary and muscular capacity [21].…”

“…Szczyt zachorowań na ALL u dzieci przypada na 2-6 r.ż.. Częstość zachorowań zmniejsza się wraz z wiekiem. Jest to heterogenna choroba nowotworowa [1,2,3].…”

“…Dieta oraz aktywność fizyczna jest jednym z niewielu modyfikowalnych zachowań, które mogą zapobiec lub opóźnić wystąpienie chorób przewlekłych związanych z otyłością. Aktywność fizyczna u dzieci z ALL poprawia sprawność fizyczną i metaboliczną, zmniejsza ryzyko wystąpienia upośledzenia fizycznego oraz poprawia jakość życia [21].…”

“…Dzieci z ALL znacznie rzadziej wykonują aktywność fizyczną niż ich zdrowi rówieśnicy, zarówno podczas, jak i po terapii [6,22]. Dzieci, które zakończyły leczenie z powodu białaczki, powinny regularnie wykonywać aktywność fizyczną dostosowaną do ich wydolności krążeniowo--oddechowej i mięśniowej [21].…”