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Physical fitness in survivors of childhood Hodgkin lymphoma: A report from the St. Jude Lifetime Cohort
Author(s) -
Wogksch Matthew D.,
Howell Carrie R.,
Wilson Carmen L.,
Partin Robyn E.,
Ehrhardt Matthew J.,
Krull Kevin R.,
Brinkman Tara M.,
Mulrooney Daniel A.,
Hudson Melissa M.,
Robison Leslie L.,
Ness Kirsten K.
Publication year - 2019
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.27506
Subject(s) - medicine , confidence interval , odds ratio , physical fitness , quality of life (healthcare) , cohort , physical therapy , pediatrics , nursing
Background There are limited data describing fitness and associated health‐related quality of life (HRQoL) in survivors of childhood Hodgkin lymphoma (HL). Procedure Fitness was evaluated among 336 adult survivors of childhood‐onset HL treated at St. Jude Children's Research Hospital and 327 controls who never had childhood cancer. The controls were frequency matched on age, sex, and race. Associations were examined between chronic disease and fitness and between fitness and HRQoL using a multivariable linear and logistic regression. Results Male survivors had lower endurance (6‐min walk [6MW] distance 604.4 ± 7.9 m vs 637.0 ± 7.5 m, P < 0.01), and worse neuropathy (modified Total Neuropathy Score [mTNS] 2.7 ± 0.2 vs 1.4 ± 0.2, P < 0.01) compared to controls. Female survivors had lower endurance (6MW distance 564.5 ± 6.9 m vs 590.6 ± 7.0 m, P < 0.01), quadriceps strength (145.7 ± 4.0 vs 163.4 ± 4.0 N·m per kilogram, P < 0.01), and worse neuropathy (mTNS 3.2 ± 0.2 vs 1.4 ± 0.3, P < 0.01) compared to controls. Moderate, severe/disabling, or life‐threatening (grades 2‐4) neurological conditions were associated with impaired quadriceps strength (odds ratio [OR] 2.94, 99% confidence interval [CI] 1.24‐6.96) and impaired endurance (OR 2.96, 99% CI 1.28‐6.69). Cardiovascular (OR 2.36, 99% CI 1.00‐5.61) and pulmonary (OR 2.78, 99% CI 1.30‐5.94) conditions were associated with impaired endurance. Quadriceps strength (β –6.44 ± 2.01, P < 0.01), endurance (β –4.63 ± 1.54, P < 0.01), and neuropathy (β –4.98 ± 1.14, P < 0.01) were associated with a lower physical component summary on the HRQoL. Conclusion Survivors of childhood HL, particularly those with neurological, cardiac, and pulmonary chronic conditions, are at risk for impaired fitness and HRQoL.