Physical Fitness and Frailty in Males after Allogeneic Hematopoietic Stem Cell Transplantation in Childhood: A Long-Term Follow-Up Study

Abstract

Purpose and methods: To analyze physical fitness, physical activity and the prevalence of frailty in male long-term survivors of pediatric allogeneic hematopoietic stem cell transplantation (HSCT). We performed a Nordic two-center study of 98 male survivors (mean age 28.7 years, range 18.5–47.0) treated with pediatric allogeneic hematopoietic stem cell transplantation (HSCT) 1980–2010 in denmark or finland. physical fitness was evaluated by the dominant hand grip-strength, timed up-and-go, sit-to-stand, gait speed and two-minute walk tests. Results: Survivors presented significantly lower muscle strength and muscle endurance in the dominant hand-grip strength (median Z-score −0.7, range −4.3–3.9) and sit-to-stand tests (median Z-score −1.5, range −3.5–2.5) compared to age and sex matched normative values of the tests. However, mobility and gait speed were not affected on a group level. The prevalence of frailty (pre-frail 20% or frail 10%) was high among the survivors. In multiple regression analysis, chronic graft-versus-host disease, shorter stature, higher body fat mass and hazardous drinking predicted prefrail/frail status. Common cardiovascular risk factors, such as increased levels of serum triglycerides, higher resting heart rate and diastolic blood pressure, were associated with lower physical fitness. Conclusion: Low muscle strength and a high incidence of frailty were observed in survivors of pediatric HSCT. There is a predominant risk of cardiovascular and metabolic diseases in the long-term.

Reproductive late effects and testosterone replacement therapy in male childhood cancer survivors: A population‐based study (the Fex‐Can study)

“…Further, survivors with TRT had 2–5 times higher prevalence of ongoing medication for cardiovascular risk factors. The increased cardiovascular risk among survivors with ongoing TRT supports advocation of a healthy lifestyle as well as active follow‐up and intervention for cardiovascular risk factors during early adulthood 11 . Additionally, testosterone deficiency has previously been associated with an increased risk for fatigue, depressive symptoms and poor sexual function 7,10,13 .…”

“…The increased cardiovascular risk among survivors with ongoing TRT supports advocation of a healthy lifestyle as well as active follow-up and intervention for cardiovascular risk factors during early adulthood. 11 Additionally, testosterone deficiency has previously been associated with an increased risk for fatigue, depressive symptoms and poor sexual function. 7,10,13 In the present study, approximately a third of the survivors with TRT had never cohabitated with a partner and only one in 10 had a biological child, despite being of similar age as survivors without TRT.…”

“…8,9 In follow-up care after cancer treatment, timely identification of the failure to develop signs of puberty is important for the teenager's psychosocial development as well as for optimizing growth and bone health. 10 Receiving testosterone replacement therapy (TRT) has in previous studies on allogeneic HSCT recipients been associated with lower muscle mass, poorer physical fitness, 11 and a higher android/ gynoid fat ratio increasing the risk of cardiometabolic disease. 12 In case of central hypogonadism, testosterone deficiency may be accompanied by deficiencies of other pituitary hormones.…”

Associations of sleeping, sedentary and physical activity with phenotypic age acceleration: a cross-sectional isotemporal substitution model

“…According to MVPA, participants were classified into two categories: MVPA < 150 min/week, MVPA ≥ 150 min/week [ 11 ]. [walking/ bicycling minutes × walking/ bicycling days] = walking/ bicycling minutes per week [ 26 ].…”

Autophagy of naïve CD4+T cells in aging – the role of body adiposity and physical fitness

“…Poor physical fitness and low physical activity level were associated with older age and cardiovascular risk factors (Refs 4–6). Further, reduced physical activity, low cardiorespiratory fitness, and poor muscle strength are associated with cardiometabolic disease (Ref.…”