Validation of an exercise booklet for children with acute lymphoblastic leukemia

Abstract Introduction: Leukemia is the most common childhood cancer, and acute lymphoblastic leukemia (ALL) accounts for 75 to 80% of all such cases in this population. Survival has increased among children and adolescents due to advances in diagnosis and treatment, with a growing emphasis on the need for rehabilitation to improve functionality and quality of life, mitigating the long-term effects of treatment. Objective: To describe the process of compiling and validating an exercise booklet for children and adolescents during and after treatment for acute lymphoblastic leukemia. Methods: Methodological study using the Delphi technique for validation. The panel of experts consisted of seven healthcare professionals and three mothers of children without ALL. The booklet was evaluated using a form containing 15 items scored on a 5-point Likert scale, and by qualitative assessment. The frequency of the expert ratings, percentage agreement and content validity index (CVI) were presented for each item and the instrument as a whole. Analyses were performed in R 3.5.1 software. Results: The booklet containing stretching, aerobics, strength and relaxation exercises was validated in the second round, reaching 100% consensus. When assessed only by the mothers, 93.33% consensus was achieved in a single round. Conclusion: The exercises booklet was validated for use in the population studied.

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Adverse drug reactions of oral dexamethasone in children and adolescents with childhood acute lymphoblastic leukemia: a systematic review

The JBI Database of Systematic Reviews and Implementation Reports ◽

10.11124/01938924-201109110-00001 ◽

2011 ◽

Vol 9 (11) ◽

pp. 371-399

Author(s):

Loh Hu ◽

Ang Neo Kim Emily ◽

Yeoh Eng Juh Allen

Keyword(s):

Systematic Review ◽

Acute Lymphoblastic Leukemia ◽

Children And Adolescents ◽

Adverse Drug Reactions ◽

Lymphoblastic Leukemia ◽

Childhood Acute Lymphoblastic Leukemia ◽

Drug Reactions ◽

Oral Dexamethasone

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No difference in outcome between children and adolescents transplanted for acute lymphoblastic leukemia in second remission

Blood ◽

10.1182/blood-2011-05-354233 ◽

2011 ◽

Vol 118 (25) ◽

pp. 6683-6690 ◽

Cited By ~ 26

Author(s):

Giorgio Dini ◽

Marco Zecca ◽

Adriana Balduzzi ◽

Chiara Messina ◽

Riccardo Masetti ◽

...

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Complete Remission ◽

Confidence Interval ◽

Children And Adolescents ◽

Lymphoblastic Leukemia ◽

Disease Recurrence ◽

Hematopoietic Stem ◽

Free Survival ◽

Total Body ◽

Related Mortality

Abstract Acute lymphoblastic leukemia (ALL) in second complete remission is one of the most common indications for allogeneic hematopoietic stem cell transplantation (HSCT) in pediatric patients. We compared the outcome after HCST of adolescents, aged 14 to 18 years, with that of children (ie, patients < 14 years of age). Enrolled in the study were 395 patients given the allograft between January 1990 and December 2007; both children (334) and adolescents (61) were transplanted in the same pediatric institutions. All patients received a myeloablative regimen that included total body irradiation in the majority of them. The donor was an HLA-identical sibling for 199 patients and an unrelated volunteer in the remaining 196 patients. Children and adolescents had a comparable cumulative incidence of transplantation-related mortality, disease recurrence, and of both acute and chronic graft-versus-host disease. The 10-year probability of overall survival and event-free survival for the whole cohort of patients were 57% (95% confidence interval, 52%-62%) and 54% (95% confidence interval, 49%-59%), respectively, with no difference between children and adolescents. This study documents that adolescents with ALL in second complete remission given HSCT in pediatric centers have an outcome that does not differ from that of patients younger than 14 years of age.

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Ethnic Disparities in Methotrexate Neurotoxicity among Children and Adolescents with Acute Lymphoblastic Leukemia

Cancer Epidemiology Biomarkers & Prevention ◽

10.1158/1055-9965.epi-21-0203 ◽

2021 ◽

Vol 30 (4) ◽

pp. 803.1-803

Author(s):

ME Scheurer ◽

AL Brown ◽

OA Taylor ◽

MB Bernhardt ◽

ZA Dreyer ◽

...

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Children And Adolescents ◽

Lymphoblastic Leukemia ◽

Ethnic Disparities

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Long-Term Effects of Treatment for Acute Lymphoblastic Leukemia with and without Cranial Irradiation on Growth and Puberty: A Comparative Study

Pediatric Research ◽

10.1203/00006450-199306000-00008 ◽

1993 ◽

Vol 33 (6) ◽

pp. 577-582 ◽

Cited By ~ 54

Author(s):

A C S Hokken-Koelega ◽

J W D Van Doorn ◽

K Hählen ◽

T Stijnen ◽

S M P F De Muinck Keizer-Schrama ◽

...

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Comparative Study ◽

Lymphoblastic Leukemia ◽

Cranial Irradiation ◽

Long Term Effects

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Adverse drug reactions of oral dexamethasone in children and adolescents with childhood acute lymphoblastic leukemia: a systematic review

JBI Library of Systematic Reviews ◽

10.11124/jbisrir-2011-93 ◽

2011 ◽

Vol 9 (11) ◽

pp. 371-399

Author(s):

Loh Hu ◽

Ang Neo Kim Emily ◽

Yeoh Eng Juh Allen

Keyword(s):

Systematic Review ◽

Acute Lymphoblastic Leukemia ◽

Children And Adolescents ◽

Adverse Drug Reactions ◽

Lymphoblastic Leukemia ◽

Childhood Acute Lymphoblastic Leukemia ◽

Drug Reactions ◽

Oral Dexamethasone

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Predictors of clinical trial enrollment and impact on outcome in children and adolescents with acute lymphoblastic leukemia: A population based study.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.7031 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 7031-7031

Author(s):

Paul James Gibson ◽

Uma H. Athale ◽

Vicky Rowena Breakey ◽

Nicole Mittmann ◽

Mylene Bassal ◽

...

Keyword(s):

Clinical Trial ◽

Clinical Trials ◽

Acute Lymphoblastic Leukemia ◽

Health System ◽

Children And Adolescents ◽

Lymphoblastic Leukemia ◽

Income Quintile ◽

Factors Associated ◽

Income Status ◽

Single Payer

7031 Background: Outcomes in pediatric acute lymphoblastic leukemia (ALL) have shown remarkable improvements in large part due to sequential clinical trials. Concerns however persist around whether access to clinical trials is equitable. It is also unclear whether patient outcomes are improved simply by enrolling on a clinical trial. Our objective was to therefore determine which patient and disease-related factors are associated with enrollment, and whether enrollment was associated with clinical outcomes among children and adolescents with ALL in a single-payer health system in Ontario, Canada. Methods: We included all Ontario patients diagnosed with ALL between 0-18 years of age from 2002-2012 treated at a pediatric center, identified through a provincial pediatric cancer registry. Clinical trial availability was determined by whether each patient’s primary institution had an open frontline trial for which the patient was eligible at the time of their diagnosis, considering individual disease characteristics such as lineage, central nervous system (CNS) status and risk group. Demographic, disease, trial enrolment, and outcome data were obtained through chart abstraction. Logistic regression models determined factors associated with trial enrolment, while Cox proportional hazard models determined factors associated with event-free and overall survival (EFS, OS). Results: Of 858 patients, 693 (81%) were eligible for an open clinical trial at their time of diagnosis. 476 (69%) enrolled on a trial. In adjusted analyses, age > 15 years (odds ratio 0.4 vs. age 5-9, 95th confidence interval (95CI) 0.2-0.8; p = 0.01) and CNS3 disease (OR 0.38 vs. CNS1, 95CI 0.17-0.83; p = 0.01) were significantly associated with decreased likelihood of enrolment, while sex and neighborhood income quintile were not associated with enrolment. Adjusted for disease and demographic factors, clinical trial enrolment was not significantly associated with either EFS (hazard ratio (HR) 1.1, 95CI 0.7-1.7; p = 0.83) or OS (HR 1.3, 95CI 0.7-2.5; p = 0.44). Conclusions: The majority of patients with ALL eligible for available clinical trials at their time of diagnosis were enrolled. While no disparities in enrolment by income status were noted, adolescents were substantially less likely to participate in trials even within pediatric centers. Studies of mechanisms underlying this disparity are warranted in order to design and implement effective interventions targeting increased enrolment rates in this patient population. Our results however also suggest that clinical trial enrolment on its own is not associated with improved outcomes in the context of a single payer health system.

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