Health-related fitness in very long-term survivors of childhood cancer: A cross-sectional study

Background: Impairment of health-related physical fitness (HRPF) in survivors of acute lymphoblastic leukemia has been shown. However, evidence of impairment in survivors of other pediatricmalignancies and possible risk factors is limited. Participants and Methods: HRPF of 17 survivors of pediatric acute myeloid leukemia (AML), 26 survivors of neuroblastoma (NBL), 28 survivors of Wilms tumor (WT) (median age 28.8 [18.8-62.6] years) after a median follow-up time of 24.5 (6.5-43.6) years, and 74 healthy controls (median age 26.9 [17.9-61.7] years). Risk factors were investigated. Testing included submaximal cardiovascular endurance (6-Minute Walk Test (6 MWT), flexibility, and muscle strength. Results: Results are expressed as mean (standard error). Survivors scored significantly lower than controls on the 6 MWT (588 +/- 6.1 m vs. controls 611 +/- 6.0 m; P = 0.008), on side flexion of the trunk (20.1 +/- 0.4 cm vs. controls 22.4 +/- 0.4 cm; P < 0.001), and on vertical jump (39.7 +/- 0.8 cm vs. controls 43.8 +/- 0.8 cm; P < 0.001). Survivors of AML had lower scores on the 6 MWT (563 +/- 12.4 m) than survivors of NBL (585 +/- 9.9 m) and survivors ofWT(606 +/- 9.6 m), P = 0.046. Being a survivor, higher body mass index (BMI) and no participation in sports were independently associated with lower scores on the 6MWT. Conclusion: Survivors of NBL, WT, and especially AML have impaired HRPF. Higher BMI and physical inactivity at adult age appeared prominent risk factors for impaired HRPF in these survivors.