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Supportive Care in Cancer
Published in: Supportive Care in Cancer 2/2021

01-02-2021 | Acute Lymphoblastic Leukemia | Original Article

Maximal cardiopulmonary exercise testing in childhood acute lymphoblastic leukemia survivors exposed to chemotherapy

Authors: Maxime Caru, Caroline Laverdière, Valerie Lemay, Simon Drouin, Laurence Bertout, Maja Krajinovic, Gregor Andelfinger, Daniel Sinnett, Daniel Curnier

Published in: Supportive Care in Cancer | Issue 2/2021

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Abstract

Purpose

The purpose of this study was to demonstrate if childhood acute lymphoblastic leukemia (ALL) survivors exposed to chemotherapy (i.e., doxorubicin) are able to achieve a safe maximal cardiopulmonary exercise test (CPET).

Methods

A total of 250 childhood ALL survivors were eligible to undergo a CPET on ergocycle. Analyses were performed in 216 survivors and stratified in regard to their prognostic risk groups: 99 survivors (55 males and 44 females) at standard risk and 117 survivors (56 males and 61 females) at high risk.

Results

Results showed that 100% (n = 216) of survivors completed a maximal CPET confirmed by the achievement of two out of three of the following criteria: 197 survivors (91.2%) reached a peak RER value of ≥ 1.15, 197 survivors (91.2%) reached a RPE score > 7, and 210 survivors (97.2%) reached a maximal heart rate ≥ 85% of the predicted value. Linear regression analysis showed a significant association between the survivors’ cumulative dose of doxorubicin and their VO2 peak measured. Two non-fatal adverse events were observed and reported at the end of the maximal CPET, while non-fatal adverse events were reported in 5 survivors during the recovery period. None of these events resulted in a long-term complication.

Conclusion

Childhood ALL survivors with prior exposure to chemotherapy can achieve a safe maximal CPET. They were able of achieving a maximal exercise test without being limited by symptoms, potential overprotection, or musculoskeletal issues. Thus, it should be the norm to realize a CPET prior a physical activity program to propose an optimal prescription. This study provides important information regarding the maximal physiological parameters that childhood ALL survivors are able to reach and have important clinical implications in the exercise and oncology field for this population of survivors.
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Metadata
Title
Maximal cardiopulmonary exercise testing in childhood acute lymphoblastic leukemia survivors exposed to chemotherapy
Authors
Maxime Caru
Caroline Laverdière
Valerie Lemay
Simon Drouin
Laurence Bertout
Maja Krajinovic
Gregor Andelfinger
Daniel Sinnett
Daniel Curnier
Publication date
01-02-2021
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 2/2021
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-020-05582-y

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