title: Physical activity and fitness in adolescent and young adult long-term survivors of childhood acute lymphoblastic leukaemia.
abstract: BACKGROUND
  There is a lack of data on physical activity (PA) and fitness of adolescent and young adult very long-term survivors of childhood acute lymphoblastic leukemia (ALL).
  
  
  METHODS
  We studied 21 childhood ALL long-term survivors (aged 16-30 years, median time since diagnosis 15.9 y), diagnosed in 1986-1996, with age- and sex-matched controls. Peak oxygen uptake (VO(2 peak)) and muscle strength were measured and physical activity index (PAI; MET h/week) calculated.
  
  
  RESULTS
  Mean VO(2 peak) of the ALL survivors was 34.8 ± 9.3 ml/kg/min. This was 14% lower than that of the controls (-5.7 ml/kg/min, 95% CI -9.4 to -1.9, p=0.01), and all the 11 female survivors performed below the age-adjusted reference values. The survivors also performed poorer in the sit-up and maximal jump tests (p=0.02 and p=0.004). Body mass index and PAI were similar in survivors and controls (p=0.34 and p=0.52). Nonetheless, as much as 30% of the male survivors and 36% of the female survivors had PAI  ≤ 5 indicating very low levels of physical activity (PA).
  
  
  CONCLUSIONS
  Insufficient PA and poor physical fitness are clinically important issues in childhood ALL long-term survivors treated with modern protocols. Girls seem to be especially at risk. PA and better physical fitness decrease cardiovascular mortality irrespective of weight. Thus, PA should be promoted throughout and after the treatment for ALL.
  
  
  CONCLUSIONS
  Since insufficient PA and poor physical fitness are an issue in very long-term ALL survivors, they should be informed on the benefits of physical activity, and be strongly encouraged to adopt a physically active lifestyle.
authors.affiliation: Department of Paediatrics, Turku University Hospital, Kiinamyllynkatu 4-8, FI-20520, Turku, Finland. liisa.jarvela@utu.fi
authors.forename: Liisa S
authors.initials: LS
authors.lastname: Järvelä
authors.forename: Harri
authors.initials: H
authors.lastname: Niinikoski
authors.forename: Päivi M
authors.initials: PM
authors.lastname: Lähteenmäki
authors.forename: Olli J
authors.initials: OJ
authors.lastname: Heinonen
authors.forename: Jukka
authors.initials: J
authors.lastname: Kapanen
authors.forename: Mikko
authors.initials: M
authors.lastname: Arola
authors.forename: Jukka
authors.initials: J
authors.lastname: Kemppainen
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008451:Maximal Voluntary Ventilation; D009043:Motor Activity / Q000502:physiology; D009765:Obesity / Q000453:epidemiology; D010809:Physical Fitness / Q000502:physiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology / Q000503:physiopathology / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data*; D055815:Young Adult