Skip to main content
Erschienen in: Journal of Cancer Survivorship 4/2010

01.12.2010

Physical activity and fitness in adolescent and young adult long-term survivors of childhood acute lymphoblastic leukaemia

verfasst von: Liisa S. Järvelä, Harri Niinikoski, Päivi M. Lähteenmäki, Olli J. Heinonen, Jukka Kapanen, Mikko Arola, Jukka Kemppainen

Erschienen in: Journal of Cancer Survivorship | Ausgabe 4/2010

Einloggen, um Zugang zu erhalten

Abstract

Introduction

There is a lack of data on physical activity (PA) and fitness of adolescent and young adult very long-term survivors of childhood acute lymphoblastic leukemia (ALL).

Methods

We studied 21 childhood ALL long-term survivors (aged 16–30 years, median time since diagnosis 15.9y), diagnosed in 1986–1996, with age- and sex-matched controls. Peak oxygen uptake (VO2peak) and muscle strength were measured and physical activity index (PAI; MET h/week) calculated.

Results

Mean VO2peak of the ALL survivors was 34.8 ± 9.3 ml/kg/min. This was 14% lower than that of the controls (−5.7 ml/kg/min, 95% CI −9.4 to −1.9, p = 0.01), and all the 11 female survivors performed below the age-adjusted reference values. The survivors also performed poorer in the sit-up and maximal jump tests (p = 0.02 and p = 0.004). Body mass index and PAI were similar in survivors and controls (p = 0.34 and p = 0.52). Nonetheless, as much as 30% of the male survivors and 36% of the female survivors had PAI ≤ 5 indicating very low levels of physical activity (PA).

Conclusions

Insufficient PA and poor physical fitness are clinically important issues in childhood ALL long-term survivors treated with modern protocols. Girls seem to be especially at risk. PA and better physical fitness decrease cardiovascular mortality irrespective of weight. Thus, PA should be promoted throughout and after the treatment for ALL.

Implications for cancer survivors

Since insufficient PA and poor physical fitness are an issue in very long-term ALL survivors, they should be informed on the benefits of physical activity, and be strongly encouraged to adopt a physically active lifestyle.
Literatur
1.
Zurück zum Zitat Horner MJ, Ries LAG, Krapcho M, Neyman N, Aminou R, Howlader N, et al. SEER Cancer Statistics Review, 1975–2006, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2006/, based on November 2008 SEER data submission, posted to the SEER web site, 2009. Horner MJ, Ries LAG, Krapcho M, Neyman N, Aminou R, Howlader N, et al. SEER Cancer Statistics Review, 1975–2006, National Cancer Institute. Bethesda, MD, http://​seer.​cancer.​gov/​csr/​1975_​2006/​, based on November 2008 SEER data submission, posted to the SEER web site, 2009.
2.
Zurück zum Zitat Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, et al. Chronic health conditions in adult survivors of childhood cancer. N Engl J Med. 2006;355:1572–82.CrossRefPubMed Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, et al. Chronic health conditions in adult survivors of childhood cancer. N Engl J Med. 2006;355:1572–82.CrossRefPubMed
3.
Zurück zum Zitat Oeffinger KC, Mertens AC, Sklar CA, Yasui Y, Fears T, Stovall M, et al. Obesity in adult survivors of childhood acute lymphoblastic leukemia: a report from the childhood cancer survivor study. J Clin Oncol. 2003;21:1359–65.CrossRefPubMed Oeffinger KC, Mertens AC, Sklar CA, Yasui Y, Fears T, Stovall M, et al. Obesity in adult survivors of childhood acute lymphoblastic leukemia: a report from the childhood cancer survivor study. J Clin Oncol. 2003;21:1359–65.CrossRefPubMed
4.
Zurück zum Zitat Florin TA, Fryer GE, Miyoshi T, Weitzman M, Mertens AC, Hudson MM, et al. Physical inactivity in adult survivors of childhood acute lymphoblastic leukemia: a report from the childhood cancer survivor study. Cancer Epidemiol Biomarkers Prev. 2007;16:1356–63.CrossRefPubMed Florin TA, Fryer GE, Miyoshi T, Weitzman M, Mertens AC, Hudson MM, et al. Physical inactivity in adult survivors of childhood acute lymphoblastic leukemia: a report from the childhood cancer survivor study. Cancer Epidemiol Biomarkers Prev. 2007;16:1356–63.CrossRefPubMed
5.
Zurück zum Zitat Ness KK, Baker KS, Dengel DR, Youngren N, Sibley S, Mertens AC, et al. Body composition, muscle strength deficits and mobility limitations in adult survivors of childhood acute lymphoblastic leukemia. Pediatr Blood Cancer. 2007;49:975–81.CrossRefPubMed Ness KK, Baker KS, Dengel DR, Youngren N, Sibley S, Mertens AC, et al. Body composition, muscle strength deficits and mobility limitations in adult survivors of childhood acute lymphoblastic leukemia. Pediatr Blood Cancer. 2007;49:975–81.CrossRefPubMed
6.
Zurück zum Zitat De Caro E, Fioredda F, Calevo MG, Smeraldi A, Saitta M, Hanau G, et al. Exercise capacity in apparently healthy survivors of cancer. Arch Dis Child. 2006;91:47–51.CrossRefPubMed De Caro E, Fioredda F, Calevo MG, Smeraldi A, Saitta M, Hanau G, et al. Exercise capacity in apparently healthy survivors of cancer. Arch Dis Child. 2006;91:47–51.CrossRefPubMed
7.
Zurück zum Zitat van Brussel M, Takken T, van der Net J, Engelbert RH, Bierings M, Schoenmakers MA, et al. Physical function and fitness in long-term survivors of childhood leukaemia. Pediatr Rehabil. 2006;9:267–74.PubMed van Brussel M, Takken T, van der Net J, Engelbert RH, Bierings M, Schoenmakers MA, et al. Physical function and fitness in long-term survivors of childhood leukaemia. Pediatr Rehabil. 2006;9:267–74.PubMed
8.
Zurück zum Zitat Hartman A, van den Bos C, Stijnen T, Pieters R. Decrease in peripheral muscle strength and ankle dorsiflexion as long-term side effects of treatment for childhood cancer. Pediatr Blood Cancer. 2008;50:833–7.CrossRefPubMed Hartman A, van den Bos C, Stijnen T, Pieters R. Decrease in peripheral muscle strength and ankle dorsiflexion as long-term side effects of treatment for childhood cancer. Pediatr Blood Cancer. 2008;50:833–7.CrossRefPubMed
9.
Zurück zum Zitat Gustafsson G, Schmiegelow K, Forestier E, Clausen N, Glomstein A, Jonmundsson G, et al. Improving outcome through two decades in childhood ALL in the nordic countries: The impact of high-dose methotrexate in the reduction of CNS irradiation. nordic society of pediatric haematology and oncology (NOPHO). Leukemia. 2000;14:2267–75.CrossRefPubMed Gustafsson G, Schmiegelow K, Forestier E, Clausen N, Glomstein A, Jonmundsson G, et al. Improving outcome through two decades in childhood ALL in the nordic countries: The impact of high-dose methotrexate in the reduction of CNS irradiation. nordic society of pediatric haematology and oncology (NOPHO). Leukemia. 2000;14:2267–75.CrossRefPubMed
10.
Zurück zum Zitat Durnin JV, Womersley J. Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. Br J Nutr. 1974;32:77–97.CrossRefPubMed Durnin JV, Womersley J. Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. Br J Nutr. 1974;32:77–97.CrossRefPubMed
11.
Zurück zum Zitat Lahti-Koski M, Taskinen O, Simila M, Männistö S, Laatikainen T, Knekt P, et al. Mapping geographical variation in obesity in Finland. Eur J Public Health. 2008;18:637–43.CrossRefPubMed Lahti-Koski M, Taskinen O, Simila M, Männistö S, Laatikainen T, Knekt P, et al. Mapping geographical variation in obesity in Finland. Eur J Public Health. 2008;18:637–43.CrossRefPubMed
12.
Zurück zum Zitat Raitakari OT, Taimela S, Porkka KV, Leino M, Telama R, Dahl M, et al. Patterns of intense physical activity among 15-to 30-year-old Finns: the cardiovascular risk in young Finns study. Scand J Med Sci Sports. 1996;6:36–9.CrossRefPubMed Raitakari OT, Taimela S, Porkka KV, Leino M, Telama R, Dahl M, et al. Patterns of intense physical activity among 15-to 30-year-old Finns: the cardiovascular risk in young Finns study. Scand J Med Sci Sports. 1996;6:36–9.CrossRefPubMed
13.
Zurück zum Zitat Viljanen T, Viitasalo JT, Kujala UM. Strength characteristics of a healthy urban adult population. Eur J Appl Physiol Occup Physiol. 1991;63:43–7.CrossRefPubMed Viljanen T, Viitasalo JT, Kujala UM. Strength characteristics of a healthy urban adult population. Eur J Appl Physiol Occup Physiol. 1991;63:43–7.CrossRefPubMed
14.
Zurück zum Zitat Shvartz E, Reibold RC. Aerobic fitness norms for males and females aged 6 to 75 years: A review. Aviat Space Environ Med. 1990;61:3–11.PubMed Shvartz E, Reibold RC. Aerobic fitness norms for males and females aged 6 to 75 years: A review. Aviat Space Environ Med. 1990;61:3–11.PubMed
15.
Zurück zum Zitat Blair SN, Kampert JB, Kohl 3rd HW, Barlow CE, Macera CA, Paffenbarger Jr RS, et al. Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA. 1996;276:205–10.CrossRefPubMed Blair SN, Kampert JB, Kohl 3rd HW, Barlow CE, Macera CA, Paffenbarger Jr RS, et al. Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA. 1996;276:205–10.CrossRefPubMed
16.
Zurück zum Zitat Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE. Exercise capacity and mortality among men referred for exercise testing. N Engl J Med. 2002;346:793–801.CrossRefPubMed Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE. Exercise capacity and mortality among men referred for exercise testing. N Engl J Med. 2002;346:793–801.CrossRefPubMed
17.
Zurück zum Zitat Wei M, Kampert JB, Barlow CE, Nichaman MZ, Gibbons LW, Paffenbarger Jr RS, et al. Relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese men. JAMA. 1999;282:1547–53.CrossRefPubMed Wei M, Kampert JB, Barlow CE, Nichaman MZ, Gibbons LW, Paffenbarger Jr RS, et al. Relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese men. JAMA. 1999;282:1547–53.CrossRefPubMed
18.
Zurück zum Zitat Laukkanen JA, Lakka TA, Rauramaa R, Kuhanen R, Venäläinen JM, Salonen R, et al. Cardiovascular fitness as a predictor of mortality in men. Arch Intern Med. 2001;161:825–31.CrossRefPubMed Laukkanen JA, Lakka TA, Rauramaa R, Kuhanen R, Venäläinen JM, Salonen R, et al. Cardiovascular fitness as a predictor of mortality in men. Arch Intern Med. 2001;161:825–31.CrossRefPubMed
19.
Zurück zum Zitat Kodama S, Saito K, Tanaka S, Maki M, Yachi Y, Asumi M, et al. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA. 2009;301:2024–35.CrossRefPubMed Kodama S, Saito K, Tanaka S, Maki M, Yachi Y, Asumi M, et al. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA. 2009;301:2024–35.CrossRefPubMed
20.
Zurück zum Zitat Hovi L, Era P, Rautonen J, Siimes MA. Impaired muscle strength in female adolescents and young adults surviving leukemia in childhood. Cancer. 1993;72:276–81.CrossRefPubMed Hovi L, Era P, Rautonen J, Siimes MA. Impaired muscle strength in female adolescents and young adults surviving leukemia in childhood. Cancer. 1993;72:276–81.CrossRefPubMed
21.
Zurück zum Zitat Warner JT, Bell W, Webb DK, Gregory JW. Relationship between cardiopulmonary response to exercise and adiposity in survivors of childhood malignancy. Arch Dis Child. 1997;76:298–303.CrossRefPubMed Warner JT, Bell W, Webb DK, Gregory JW. Relationship between cardiopulmonary response to exercise and adiposity in survivors of childhood malignancy. Arch Dis Child. 1997;76:298–303.CrossRefPubMed
22.
Zurück zum Zitat Jarfelt M, Fors H, Lannering B, Bjarnason R. Bone mineral density and bone turnover in young adult survivors of childhood acute lymphoblastic leukaemia. Eur J Endocrinol. 2006;154:303–9.CrossRefPubMed Jarfelt M, Fors H, Lannering B, Bjarnason R. Bone mineral density and bone turnover in young adult survivors of childhood acute lymphoblastic leukaemia. Eur J Endocrinol. 2006;154:303–9.CrossRefPubMed
23.
Zurück zum Zitat Helakorpi S, Prättälä R, Uutela A. Health behaviour and health among the finnish adult population, spring 2007. Publications of the National Public Health Institute. 2008;6:1–198. Helakorpi S, Prättälä R, Uutela A. Health behaviour and health among the finnish adult population, spring 2007. Publications of the National Public Health Institute. 2008;6:1–198.
24.
Zurück zum Zitat Jarfelt M, Lannering B, Bosaeus I, Johannsson G, Bjarnason R. Body composition in young adult survivors of childhood acute lymphoblastic leukaemia. Eur J Endocrinol. 2005;153:81–9.CrossRefPubMed Jarfelt M, Lannering B, Bosaeus I, Johannsson G, Bjarnason R. Body composition in young adult survivors of childhood acute lymphoblastic leukaemia. Eur J Endocrinol. 2005;153:81–9.CrossRefPubMed
25.
Zurück zum Zitat Harila-Saari AH, Huuskonen UE, Tolonen U, Vainionpää LK, Lanning BM. Motor nervous pathway function is impaired after treatment of childhood acute lymphoblastic leukemia: a study with motor evoked potentials. Med Pediatr Oncol. 2001;36:345–51.CrossRefPubMed Harila-Saari AH, Huuskonen UE, Tolonen U, Vainionpää LK, Lanning BM. Motor nervous pathway function is impaired after treatment of childhood acute lymphoblastic leukemia: a study with motor evoked potentials. Med Pediatr Oncol. 2001;36:345–51.CrossRefPubMed
26.
Zurück zum Zitat Shankar SM, Marina N, Hudson MM, Hodgson DC, Adams MJ, Landier W, et al. Monitoring for cardiovascular disease in survivors of childhood cancer: report from the cardiovascular disease task force of the children’s oncology group. Pediatrics. 2008;121:e387–96.CrossRefPubMed Shankar SM, Marina N, Hudson MM, Hodgson DC, Adams MJ, Landier W, et al. Monitoring for cardiovascular disease in survivors of childhood cancer: report from the cardiovascular disease task force of the children’s oncology group. Pediatrics. 2008;121:e387–96.CrossRefPubMed
27.
Zurück zum Zitat Jenney ME, Faragher EB, Jones PH, Woodcock A. Lung function and exercise capacity in survivors of childhood leukaemia. Med Pediatr Oncol. 1995;24:222–30.CrossRefPubMed Jenney ME, Faragher EB, Jones PH, Woodcock A. Lung function and exercise capacity in survivors of childhood leukaemia. Med Pediatr Oncol. 1995;24:222–30.CrossRefPubMed
28.
Zurück zum Zitat Ganame J, Claus P, Uyttebroeck A, Renard M, D’hooge J, Bijnens B, et al. Myocardial dysfunction late after low-dose anthracycline treatment in asymptomatic pediatric patients. J Am Soc Echocardiogr. 2007;20:1351–8.CrossRefPubMed Ganame J, Claus P, Uyttebroeck A, Renard M, D’hooge J, Bijnens B, et al. Myocardial dysfunction late after low-dose anthracycline treatment in asymptomatic pediatric patients. J Am Soc Echocardiogr. 2007;20:1351–8.CrossRefPubMed
29.
Zurück zum Zitat Lucia A, Earnest C, Perez M. Cancer-related fatigue: can exercise physiology assist oncologists? Lancet Oncol. 2003;4:616–25.CrossRefPubMed Lucia A, Earnest C, Perez M. Cancer-related fatigue: can exercise physiology assist oncologists? Lancet Oncol. 2003;4:616–25.CrossRefPubMed
30.
Zurück zum Zitat San Juan AF, Fleck SJ, Chamorro-Vina C, Mate-Munoz JL, Moral S, Perez M, et al. Effects of an intrahospital exercise program intervention for children with leukemia. Med Sci Sports Exerc. 2007;39:13–21.CrossRefPubMed San Juan AF, Fleck SJ, Chamorro-Vina C, Mate-Munoz JL, Moral S, Perez M, et al. Effects of an intrahospital exercise program intervention for children with leukemia. Med Sci Sports Exerc. 2007;39:13–21.CrossRefPubMed
Metadaten
Titel
Physical activity and fitness in adolescent and young adult long-term survivors of childhood acute lymphoblastic leukaemia
verfasst von
Liisa S. Järvelä
Harri Niinikoski
Päivi M. Lähteenmäki
Olli J. Heinonen
Jukka Kapanen
Mikko Arola
Jukka Kemppainen
Publikationsdatum
01.12.2010
Verlag
Springer US
Erschienen in
Journal of Cancer Survivorship / Ausgabe 4/2010
Print ISSN: 1932-2259
Elektronische ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-010-0131-0

Weitere Artikel der Ausgabe 4/2010

Journal of Cancer Survivorship 4/2010 Zur Ausgabe

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.