Physical training interventions for children and teenagers affected by acute lymphoblastic leukemia and related treatment impairments

Simioni, Carolina; Zauli, Giorgio; Martelli, Alberto M.; Vitale, Marco; Ultimo, Simona; Milani, Daniela; Neri, Luca M.

doi:10.18632/oncotarget.24762

Cited by 29 publications

(24 citation statements)

References 98 publications

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“…www.e-apem.org intervention effect on total body BMD. 72) Intrahospital supervised exercise may also considerably improve children's quality of life (QoL) and overall health status during treatment periods. 73)…”

Section: Management and Recommendationsmentioning

confidence: 99%

Bone morbidity in pediatric acute lymphoblastic leukemia

Ahn

Suh

2020

Ann Pediatr Endocrinol Metab

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Acute lymphoblastic leukemia (ALL), currently the most common pediatric leukemia, has a high curability rate of up to 90%. Endocrine disorders are highly prevalent in children with ALL, and skeletal morbidity is a major issue induced by multiple factors associated with ALL. Leukemia itself is a predominant risk factor for decreased bone formation, and major bone destruction occurs secondary to chemotherapeutic agents. Glucocorticoids are cornerstone drugs used throughout the course of ALL treatment that exert significant effects on demineralization and osteoclastogenesis. After completion of treatment, ALL survivors are prone to multiple hormone deficiencies that eventually affect bone mineral accrual. Dualenergy X-ray absorptiometry, the most widely used method of measuring bone mineral density, is used to determine the presence of childhood osteoporosis and vertebral fracture. Supplementation with calcium and vitamin D, administration of pyrophosphate analogues, and promotion of mobility and exercise are effective options to prevent further bone resorption and fracture incidence. This review focuses on addressing bone morbidity after pediatric ALL treatment and provides an overview of bone pathology based on skeletal outcomes to increase awareness among pediatric hemato-oncologists and endocrinologists.

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Section: Management and Recommendationsmentioning

confidence: 99%

Bone morbidity in pediatric acute lymphoblastic leukemia

Ahn

Suh

2020

Ann Pediatr Endocrinol Metab

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“…It was conducted among children after cancer treatment who did not participate in supervised rehabilitation programs. Most studies in this domain usually assess the impact of particular rehabilitation programs and activities on physical fitness and quality of life [18,19,20,36,37]. However, our study shows the functional status of children who were not involved in the rehabilitation process despite severe treatment.…”

Section: Discussionmentioning

confidence: 69%

“…As a result, it is crucial to implement early rehabilitation and encourage young patients to undertake physical activity by providing them with access to physical activities focused on the interests of a given age group depending on sex. Simioni et al [20] showed that properly selected physical activity in pediatric patients during and after cancer treatment results in a number of favorable changes. It positively influences musculoskeletal and neuromuscular systems, improves cardiovascular and respiratory parameters, increasing physical capacity and reducing metabolic disorders.…”

Section: Discussionmentioning

confidence: 99%

“…Studies on children after cancer treatment indicate a linear relationship between physical activity and the quality of life and general fitness [10]. While the quality of life of these patients is the subject of numerous studies [11,12,13,14,15,16], the assessment of physical fitness primarily refers to supervised rehabilitation programs that are limited in time [17,18,19,20]. Daily physical activity, which is a lifestyle affecting general physical fitness, is a very important and still underestimated factor of both primary and secondary cancer prevention.…”

Section: Introductionmentioning

confidence: 99%

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Physical Fitness of School-Age Children after Cancer Treatment

Malicka

Mrowiec

Sajkiewicz

et al. 2019

IJERPH

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The aim of the study was to assess physical fitness of school-age children after cancer treatment. The study was comprised of one hundred and fifty six children—children after cancer treatment (n = 71, mean age 11.22 ± 3.11 years) vs. healthy children previously untreated for cancer (n = 85, mean age 10.71 ± 1.22 years). Physical fitness was assessed indirectly based on a ball throw (assessment of strength, coordination, and upper limb speed), long jump (assessment of jumping ability, speed, and coordination), and a 60 m run (assessment of speed). The analysis was performed based on the Student’s t-test for independent samples and the analysis of variance and the post-hoc least significant difference test (LSD test). Children from the study group threw the ball closer and had shorter long jump performance compared to the control group, i.e., 12.93 [m] vs. 19.79 [m], respectively (p < 0.001) and 2.46 [m] vs. 2.70 [m], respectively (p = 0.02). However, their mean running time was longer, i.e., 13.33 [s] vs. 11.73 [s], respectively (p = 0.01). Division according to sex showed additionally significantly shorter ball throw distance in the study group in both girls (p = 0.001) and boys (p < 0.001), significantly shorter jump length in the group of girls (p = 0.01), and significantly longer running time in the group of boys (p = 0.04). Children treated for cancer are characterized by decreased physical fitness, and motor ability is sex-dependent. Both groups showed decreased strength, coordination, and upper limb speed. Additionally, worse jumping ability was found in girls whereas decreased speed was observed in boys.

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“…ALL patients also are at a higher risk of developing metabolic syndrome, which again is amplified by physical inactivity both during and after therapy. Recently, several physical training intervention protocols have become available for children with ALL, and promising results regarding both obesity and metabolic alterations are being published [26]. Hence, nutritional counseling should be provided and physical activity promoted both during and after the cessation of ALL treatment in order to decrease subsequent long-term health risks.…”

Section: Discussionmentioning

confidence: 99%

Trends in age- and sex-adjusted body mass index and the prevalence of malnutrition in children with cancer over 42 months after diagnosis: a single-center cohort study

et al. 2019

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The adequate nutritional status of pediatric cancer patients is particularly important to enable them to cope with the demands of the disease and its treatment and to maintain normal growth. Malnutrition and obesity have both been associated with reduced survival and increased drug toxicity. We investigated trends in the age-and sex-adjusted body mass index (ISO-BMI) and the prevalence of malnutrition in a Finnish cohort of 139 consecutive children receiving chemotherapy for cancer, with a follow-up period of 42 months after diagnosis. In total, 28% (39/139) of the patients experienced malnutrition (ISO-BMI < 17 or > 10% weight loss), and 12% (16/139) had a nasogastric tube or underwent gastrostomy. Patients with acute or chronic myeloid leukemia (5/10), central nervous system (CNS) tumors (5/13), or solid tumors (13/31) most frequently suffered from malnutrition. There was a significant increase in the ISO-BMI of patients with acute lymphoblastic leukemia (ALL) (+ 2.1 kg/m 2) and lymphomas (+ 2.4 kg/m 2) during the first 6 months, and the ISO-BMI of patients with ALL remained higher at 42 months compared to baseline (+ 1.9 kg/m 2). Conclusion: The cumulative incidence of malnutrition in Finnish pediatric cancer patients is comparable to that reported in other populations. The nutritional status of patients with acute myeloid leukemia, CNS tumors, or solid tumors should be monitored with extra care to facilitate early intervention in the case of impending malnutrition. What is known: • Both malnutrition and obesity are associated with reduced survival and increased drug toxicity in pediatric cancer patients. What is new: • Overall, 28 % of Finnish children receiving chemotherapy for cancer suffer from malnutrition during the first 42 months following the initial cancer diagnosis. • ISO-BMI curves from initial diagnosis to 42 months after diagnosis are provided for patients with different types of cancer.

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Physical training interventions for children and teenagers affected by acute lymphoblastic leukemia and related treatment impairments

Cited by 29 publications

References 98 publications

Bone morbidity in pediatric acute lymphoblastic leukemia

Bone morbidity in pediatric acute lymphoblastic leukemia

Physical Fitness of School-Age Children after Cancer Treatment

Trends in age- and sex-adjusted body mass index and the prevalence of malnutrition in children with cancer over 42 months after diagnosis: a single-center cohort study

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