Academic Journal
Physical frailty deteriorates after a 5‐day dexamethasone course in children with acute lymphoblastic leukemia, results of a national prospective study
| العنوان: | Physical frailty deteriorates after a 5‐day dexamethasone course in children with acute lymphoblastic leukemia, results of a national prospective study |
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| المؤلفون: | Verwaaijen, Emma J., van Hulst, Annelienke M., Hartman, Annelies, Pieters, Rob, Fiocco, Marta, Pluijm, Saskia M. F., van Litsenburg, Raphaële R. L., Grootenhuis, Martha A., van den Akker, Erica L. T., van den Heuvel‐Eibrink, Marry M. |
| المساهمون: | Stichting Kinderen Kankervrij |
| المصدر: | Cancer Medicine ; volume 12, issue 24, page 22304-22315 ; ISSN 2045-7634 2045-7634 |
| بيانات النشر: | Wiley |
| سنة النشر: | 2023 |
| المجموعة: | Wiley Online Library (Open Access Articles via Crossref) |
| الوصف: | Background Dexamethasone is important in the treatment for pediatric acute lymphoblastic leukemia (ALL) but induces muscle atrophy with negative consequences for muscle mass, muscle strength, and functional abilities. The aim of this study was to establish the effect of a dexamethasone course on sarcopenia and physical frailty in children with ALL, and to explore prognostic factors. Methods Patients with ALL aged 3–18 years were included during maintenance therapy. Patients had a sarcopenia/frailty assessment on the first day of (T1) and on the day after (T2) a 5‐day dexamethasone course. Sarcopenia was defined as low muscle strength in combination with low muscle mass. Prefrailty and frailty were defined as having two or ≥three of the following components, respectively: low muscle mass, low muscle strength, fatigue, slow walking speed, and low physical activity. Chi‐squared and paired t ‐tests were used to assess differences between T1 and T2. Logistic regression models were estimated to explore patient‐ and therapy‐related prognostic factors for frailty on T2. Results We included 105 patients, 61% were boys. Median age was 5.3 years (range: 3–18.8). At T1, sarcopenia, prefrailty, and frailty were observed in respectively 2.8%, 23.5%, and 4.2% of patients. At T2, the amount of patients with frailty had increased to 17.7% ( p = 0.002), whereas the number of patients with sarcopenia and prefrailty remained similar. Higher ASMM (odds ratio [OR]: 0.49, 95% CI: 0.28–0.83), stronger handgrip strength (OR: 0.41, 95% CI: 0.22–0.77) and more physical activity minutes per day (OR: 0.98, 95% CI: 0.96–0.99) decreased the risk of frailty at T2. Slower walking performance (OR: 2, 95% CI: 1.2–3.39) increased the risk. Fatigue levels at T1 were not associated with frailty at T2. Conclusion Physical frailty increased strikingly after a 5‐days dexamethasone course in children with ALL. Children with poor physical state at start of the dexamethasone course were more likely to be frail after the course. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1002/cam4.6779 |
| الاتاحة: | http://dx.doi.org/10.1002/cam4.6779 https://onlinelibrary.wiley.com/doi/pdf/10.1002/cam4.6779 |
| Rights: | http://creativecommons.org/licenses/by/4.0/ |
| رقم الانضمام: | edsbas.2AF5356E |
| قاعدة البيانات: | BASE |
| DOI: | 10.1002/cam4.6779 |
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