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Balance in children with acute lymphoblastic leukemia
Author(s) -
Varedi Mitra,
McKenna Raymond,
Lamberg Eric M
Publication year - 2017
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.13141
Subject(s) - medicine , lymphoblastic leukemia , balance (ability) , pediatrics , leukemia , physical medicine and rehabilitation
Background Treatment for acute lymphoblastic leukemia ( ALL ) can affect balance via different mechanisms, including sensory and motor peripheral neuropathy, cognitive impairment, and reduced muscle strength and flexibility. To provide an overview of what is currently known about the effects of cancer treatment on balance in pediatric ALL patients and survivors, and of the predictors of poor balance, a review of the literature was conducted. Methods Five databases were searched for English‐language original research articles on balance during or after treatment for pediatric ALL . Results From a total of nine studies, six identified significant balance problems in children with ALL during or after treatment. The percentage of patients or survivors with impaired balance varied between 27% and 69% during treatment, 7% and 65% a few years after completion of treatment, and 14% and 17% many years after the completion of treatment. Factors associated with impaired balance were higher body mass index; higher intrathecal methotrexate dose; cranial radiation; knee extensor weakness; and impaired cognition. Conclusion Although heterogeneity between the studies regarding patient age; age at diagnosis; time since completion of treatment; and methods of quantifying balance make it difficult to reach a single conclusion, the evidence suggests that survivors may experience short‐ and/or long‐term balance difficulties. While there is a need for additional studies to better understand the effects of impaired balance in survivors, clinicians treating both child and adult survivors of ALL need to be aware of these potential risks.