Physical Impairments, Activity Limitations, and Participation Restrictions of Childhood Acute Lymphoblastic Leukemia Survivors with and Without Hip Osteonecrosis: a PETALE Cohort Study

Overview

Journal J Cancer Surviv

Specialty Oncology

Date 2024 May 24

PMID 38787491

Authors

Annie Brochu

Dahlia Kairy

Nathalie Alos

Caroline Laverdiere

Daniel Sinnett

Serge Sultan

Daniel Curnier

Marie-Claude Miron

Ramy El-Jalbout

Melissa Fiscaletti

Luc J Hebert

Affiliations

Soon will be listed here.

Abstract

Purpose: Long-term musculoskeletal complications represent a growing burden for survivors of childhood acute lymphoblastic leukemia (cALL). This study aimed to describe physical impairments, activity limitations, and participation restrictions in a high-risk subgroup of cALL survivors of the PETALE cohort.

Methods: This cross-sectional study, using observational data from the PETALE cohort, included a subgroup of survivors who presented high-risk criteria for late effects. Outcomes measures consisted of hip magnetic resonance imaging, maximal isometric muscle strength (MIMS) or torque (MIMT), range of motion (ROM), Near Tandem Balance (NTB), 6-Minute Walk Test (6MWT), Five Time Sit-to-Stand Test (FTSST), and health-related quality of life. Descriptive statistics and regression analyses were performed.

Results: Survivors (n = 97, 24.2 ± 6.7 years old) showed limited grip strength, FTSST, and NTB performance compared to reference values (p < 0.001). Thirteen participants (14.6%, 18 hips) had hip osteonecrosis (ON) (53.8% male). Higher severity hip ON was found in female survivors (66.7% vs. 22.2%). Survivors with hip ON had reduced hip external rotation ROM compared to those without (p < 0.05). Relationships were found between MIMS and ROM outcomes (r = 0.32, p < 0.01) and with 6MWT (r = 0.39-0.41, p < 0.001). Our multiple linear regression model explained 27.6% of the variance of the 6MWT.

Conclusions: Survivors in our subgroup had clinically significant physical impairments and activity limitations, and those with hip ON showed worst hip impairment outcomes.

Implications For Cancer Survivors: These findings emphasize the importance of long-term follow-up including physical therapy assessment to help early identification and management of physical impairments and activity limitations in survivors of cALL.

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