title: Frailty in childhood cancer survivors.
abstract: Young adult childhood cancer survivors are at an increased risk of frailty, a physiologic phenotype typically found among older adults. This phenotype is associated with new-onset chronic health conditions and mortality among both older adults and childhood cancer survivors. Mounting evidence suggests that poor fitness, muscular weakness, and cognitive decline are common among adults treated for childhood malignancies, and that risk factors for these outcomes are not limited to those treated with cranial radiation. Although the pathobiology of this phenotype is not known, early cellular senescence, sterile inflammation, and mitochondrial dysfunction in response to initial cancer or treatment-related insults are hypothesized to play a role. To the authors' knowledge, interventions to prevent or remediate frailty among childhood cancer survivors have not been tested to date. Pharmaceutical, nutraceutical, and lifestyle interventions have demonstrated some promise.
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Ness
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Armstrong
authors.forename: Mondira
authors.initials: M
authors.lastname: Kundu
authors.forename: Carmen L
authors.initials: CL
authors.lastname: Wilson
authors.forename: Tamara
authors.initials: T
authors.lastname: Tchkonia
authors.forename: James L
authors.initials: JL
authors.lastname: Kirkland
mesh_terms: D000328:Adult; D016922:Cellular Senescence; D002648:Child; D002908:Chronic Disease; D060825:Cognitive Dysfunction / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D016371:Cranial Irradiation / Q000009:adverse effects; D019587:Dietary Supplements / Q000706:statistics & numerical data; D017079:Exercise Tolerance; D018737:Hand Strength; D006801:Humans; D015994:Incidence; D007249:Inflammation; D008928:Mitochondria; D018908:Muscle Weakness / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D009369:Neoplasms; D012307:Risk Factors; D040242:Risk Reduction Behavior; D017741:Survivors / Q000706:statistics & numerical data*
keywords: aging; childhood cancer survivor; fitness; frailty; inflammation; mitochondrial dysfunction; senescence; weakness