Exercise Cardiorespiratory Indexes in ChildrenMotivated to Physical Activity After Treatment for Acute Lymphoblastic Leukemia

Overview

Background.
Children treated for acute lymphoblastic leukemia (ALL) with anthracycline antibiotic agents mustbe followed up for the danger of late cardiotoxic effects of the treatment. Another threat represents the consequenceof the protective upbringing and inactive lifestyle. The aim of present study was to assess the exercise cardiorespiratoryindexes and anthropometric variables in previously treated children without clinical, ECG and echocardiographicsigns of cardiotoxicity, who had been motivated to physical activity.Methods and Results. 29 children (12.3±2.7 years old) previously treated for ALL with anthracyclines wereexamined. The cumulative dosis of anthracyclines was 224±39.4 mg/m2. The treatment was finished before 4.8±2.1years and after this period no signs of the late cardiotoxicity were detectable. Both children and their parents wereencouraged to the regular physical activity of submaximal intensity. 29 age-and sex-matched control subjects werehealthy children, never limited in their activities, but without special physical training. As soon as the basicanthropometric data had been verified, both groups completed a progressive exercise test with the assessment ofsubmaximal and maximal spiroergometric indexes. In all parameters followed we failed to prove any significantdifferences between the two groups. The treated children exhibited only slightly lower body height, higher bodyweight and higher percentage of body fat. They reached lower respiratory exchange ratio (R), with higher oxygenuptake on both submaximal and maximal load levels.Conclusions. When sufficiently motivated, children surviving five years after the treatment with anthracycline forALL, who have no signs of cardiotoxic effects, have their functional cardiorespiratory capacity approximatelycomparable to that of healthy children.

Key words:
children, leukemia, anthracyclines, physical activity, spiroergometry.