Skeletal, neuromuscular and fitness impairments among children with newly diagnosed acute lymphoblastic leukemia

Abstract

This study describes skeletal, neuromuscular and fitness impairments among 109 children (median age 10 [range 4–18] years, 65.1% male, 63.3% white) with acute lymphoblastic leukemia (ALL). Outcomes were measured 7–10 days after diagnosis and compared to age- and sex-specific expected values. Associations between function and health-related quality of life (HRQL) were evaluated with logistic regression. Children with ALL had sub-optimal bone mineral density (BMD) Z-score/height (mean ± standard error: − 0.53 ± 0.16 vs. 0.00 ± 0.14, p < 0.01), body mass index percentile (57.6 ± 3.15 vs. 50.0 ± 3.27%, p = 0.02), quadriceps strength (201.9 ± 8.3 vs. 236.1 ± 5.4 N, p < 0.01), 6 min walk distance (385.0 ± 13.1 vs. 628.2 ± 7.1 m, p < 0.001) and Bruininks–Oseretsky Test of Motor Proficiency scores (23 ± 2.5 vs. 50 ± 3.4%, p < 0.01). Quadriceps weakness was associated with a 20.9-fold (95% confidence interval 2.5–173.3) increase in poor physical HRQL. Children with newly diagnosed ALL have weakness and poor endurance and may benefit from early rehabilitation that includes strengthening and aerobic conditioning.

Keywords::

• Acute lymphoblastic leukemia
• pediatric
• muscle strength
• physical endurance
• quality of life

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article at www.informahealthcare.com/lal.

This work (NCT00902213) was supported by National Institutes of Health grants R01 CA129384 (C. L. Cox, PI) and CA21765 (R. J. Gilbertson, PI) and by the American Lebanese Syrian Associated Charities (ALSAC).

Notes

^a GE Healthcare Lunar, P. O. Box 7550, Madison, WI 53707

^b Hologic Inc., 35 Crosby Drive, Bedford, MA 01730

^c BioClinica Technologies, 826 Newtown-Yardley Rd, Newtown, PA 18940

^d Scale-Tronix, 200 East Post Road, White Plains, NY 10601

^e AliMed, 287 High Street, Dedham, MA 01026

^f Chatillon Ametek Test & Calibration Instruments, 8600 Comerset Drive, Largo, FL 33773

^g Patterson Medical Holdings, 1000 Remington Boulevard, Suite 210, Bolingbrook, IL 60440

^h Pearson, 19500 Bulverde Road, San Antonio, TX 78259

ⁱ HealthActCHQ, 800 Boylston Street, 16th Floor, Boston, MA 02199

^j SAS Institute Inc., 100 SAS Campus Drive, Cary, NC 27513