Within 5‐year off‐chemotherapy: How the cardio‐respiratory response to exercise is related to energy expenditure, fatigue, and adiposity in children with acute lymphoblastic leukaemia?

Abstract

Acute lymphoblastic leukaemia (ALL) is the most prevalent type of malignancy among children. Contemporary therapies such as chemotherapy and radiotherapy have helped cure these cases and increased the survival rates to about 80%-90% (Gaynon et al., 2010). Despite the favourable effects, many adverse sequelae have been recognised to result from those therapies in both in the short and long term (Kızılocak & Okcu, 2019). The nature and extent of these effects are reliant on the type and dosage of the therapies that were received. Survivors of ALL have been recognised to be at a substantially increased risk of growth and pubertal abnormalities, neuropsychological disorders and obesity after treatment with cranial irradiation (Langer et al., 2002;Oeffinger et al., 2003;Vandecruys et al., 2013). It also has been observed that the cardio-respiratory fitness in survivors of ALL is remarkably lower compared with healthy controls (Caru et al., 2019), as a result of the cardiotoxic effects of treatments (i.e., anthracycline) (Lipshultz et al., 2008). Impaired cardio-respiratory function and muscle weakness

Cancer-Related Fatigue and Daily Living Activities in Pediatric Cancer Survivors

“…According to our study, in terms of CNS vs ALL group, probably because ALL group was older in age and a longer period of time had passed since the end of the treatment, a lower level of fatigue was detected in that ALL group. The average time since diagnosis was under 10 years in our study and those aformentioned studies 9,22,24,25 . This is a shorter time than that of Mulroney et al, 12 Meeske et al, 13 and Langeveld et al 19 in which fatigue levels declined over time during the long follow-up of survivors.…”

“…The average time since diagnosis was under 10 years in our study and those aformentioned studies. 9,22,24,25 This is a shorter time than that of Mulroney et al, 12 Meeske et al, 13 and Langeveld et al 19 in which fatigue levels declined over time during the long follow-up of survivors. Tumor type, in our study, which indicates high number of patients with CNS tumor (41.6% of total) was found to be associated with higher fatigue scores.…”

The Impact of a Precision-Based Exercise Intervention in Childhood Hematological Malignancies Evaluated by an Adapted Yo-Yo Intermittent Recovery Test

“…Although the Yo-Yo AD test was adapted to allow all the participants to perform it, some CAYA-H presented a mild-to-severe inefficiency in their oxidative metabolism pathways [ 4 ]. In case of severe atrophy, the stores of muscle glycogen can be very low, and the rate of glycolysis can be more pronounced than when the aerobic component is still efficient [ 8 ]. For these CAYA-H, the test can be comparable to the Yo-Yo IR2 of Bangsbo et al, where the efficiency of a healthy cardiopulmonary system is deeply strained.…”

“…Furthermore, CAYA-H’s fate is to become accustomed to decreasing social inclusion opportunities, notably those related to participation in sports training and competition, due to their impaired individual exercise capacity and immunological status [ 3 ]. Exercise capacity is still reduced at the end of cancer treatment, after individuals are off therapy for 1 to 5 years, and even after 15 years of follow-up, ultimately limiting individuals’ full self-realization in society and jeopardizing their transition towards adulthood [ 4 , 5 , 6 , 7 , 8 ]. CAYA-H and their families all over the world share a common path of uncertainty after surviving cancer, and experience compromised exercise ability in the long term.…”