Effects of Exercise Interventions on Immune Function in Children and Adolescents With Cancer and HSCT Recipients - A Systematic Review

BackgroundPediatric cancer patients are at high risk for life-threatening infections, therapy associated complications and cancer-related side effects. Exercise is a promising tool to support the immune system and reduce inflammation. The primary objective of this systematic review was to evaluate the effects of exercise interventions in pediatric cancer patients and survivors on the immune system.MethodsFor this systematic review (PROSPERO ID: CRD42021194282) we searched four databases (MEDLINE, Cochrane Library, ClinicalTrials.gov, SPORTDiscus) in June 2021. Studies with pediatric patients with oncological disease were included as main criterion. Two authors independently performed data extraction, risk of bias assessment, descriptive analysis and a direction ratio was calculated for all immune cell parameters.FindingsOf the 1448 detected articles, eight studies with overall n = 400 children and adolescents with cancer and n = 17 healthy children as controls aged 4-19 years met the inclusion criteria. Three randomized, four non-randomized controlled trials and one case series were analyzed descriptively. The exercise interventions had no negative adverse effects on the immune system. Statistically significant results indicated enhanced cytotoxicity through exercise, while changes in immune cell numbers did not differ significantly. Interventions further reduced days of in-hospitalization and reduced the risk of infections. Several beneficial direction ratios in immune parameters were identified favoring the intervention group.InterpretationExercise interventions for pediatric cancer patients and survivors had no negative but promising beneficial effects on the immune system, especially regarding cytotoxicity, but data is very limited. Further research should be conducted on the immunological effects of different training modalities and intensities, during various treatment phases, and for different pediatric cancer types. The direction ratio parameters given here may provide useful guidance for future clinical trials.Systemic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021194282, Prospero ID: CRD42021194282.

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Non-pharmacological sleep interventions for pediatric cancer patients and survivors: a systematic review protocol

Systematic Reviews ◽

10.1186/s13643-021-01724-3 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Peter L. Stavinoha ◽

Ineke M. Olsthoorn ◽

Maria C. Swartz ◽

Sara Nowakowski ◽

Stephanie J. Wells ◽

...

Keyword(s):

Systematic Review ◽

Sleep Quality ◽

Cancer Patients ◽

Pediatric Cancer ◽

Sleep Disturbances ◽

Sleep Onset ◽

Standard Of Care ◽

Sleep Diary ◽

Pharmacological Interventions ◽

Pediatric Cancer Patients

Abstract Background Sleep disturbances constitute a common complication in pediatric cancer patients and survivors and are frequently severe enough to warrant treatment. Suboptimal sleep has been associated with decreased emotional well-being and cognitive functioning and increased behavioral problems. Standardized guidelines for non-pharmacological sleep interventions for adults with cancer exist, but no standard of care intervention or standard guidelines are available to guide such intervention in pediatric cancer patients and survivors. Therefore, effective behavioral interventions for improving sleep quality need to be identified. The objective of the review is to evaluate the effect of non-pharmacological sleep interventions on sleep quality in pediatric cancer patients and survivors. Methods The review will consider studies that include children and adolescents between 0 and 18 years diagnosed with cancer or who have a history of cancer who have non-respiratory sleep disturbance. We will include experimental and quasi-experimental studies evaluating non-pharmacological interventions such as psychological interventions, technical/device interventions, interventions targeting physical activity, and complementary and alternative medicine interventions (e.g., yoga, massage, music). Interventions involving medications, ingestible supplements, products purported to work through absorption, and medical devices will be excluded. Primary outcome will be sleep quality as measured by methods including retrospective ratings, daily sleep diary, and validated questionnaires. Secondary outcomes will include total sleep time, sleep onset latency, wake after sleep onset, daytime sleepiness, and daytime sleep duration (naps) as measured by retrospective ratings, daily sleep diary, validated questionnaires, and/or actigraphy. Databases will include MEDLINE (Ovid), EMBASE (Ovid), Cochrane Library, CINAHL (Ebsco), and PsycINFO (Ovid) and will be queried from database inception to present. Two reviewers will independently screen all citations, full-text articles, and extract data. The study methodological quality will be assessed using Joanna Briggs Institute (JBI) critical appraisal tools. Data will be extracted and findings pooled and synthesized using a meta-aggregation approach via the JBI System for the Unified Management, Assessment, and Review of Information (SUMARI). If feasible, we will conduct random effects meta-analysis. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g., methodological quality, study design, outcome measures). Discussion This systematic review will synthesize and consolidate evidence on existing non-pharmacological interventions to improve sleep in pediatric cancer patients and survivors. Findings may help inform practitioners working with pediatric cancer patients and survivors experiencing sleep disturbances and is intended to identify gaps and opportunities to improve methodical quality of further non-pharmacological sleep intervention research in this population toward developing an eventual standard of care. Systematic review registration PROSPERO CRD42020200397.

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A Systematic Review of Interventions with Siblings of Pediatric Cancer Patients

Child Health Nursing Research ◽

10.4094/chnr.2017.23.3.394 ◽

2017 ◽

Vol 23 (3) ◽

pp. 394-404 ◽

Cited By ~ 1

Author(s):

Soo-yeon Han ◽

Ji-Hye Hwang ◽

Cho-hee Kim ◽

Hye-young Jang ◽

Kyung-Sook Bang

Keyword(s):

Systematic Review ◽

Cancer Patients ◽

Pediatric Cancer ◽

Pediatric Cancer Patients

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Systematic review of antimicrobial lock therapy for prevention of central-line-associated bloodstream infections in adult and pediatric cancer patients

International Journal of Antimicrobial Agents ◽

10.1016/j.ijantimicag.2017.06.013 ◽

2017 ◽

Vol 50 (3) ◽

pp. 308-317 ◽

Cited By ~ 20

Author(s):

LeAnn B. Norris ◽

Farah Kablaoui ◽

Maggie K. Brilhart ◽

P. Brandon Bookstaver

Keyword(s):

Systematic Review ◽

Cancer Patients ◽

Pediatric Cancer ◽

Bloodstream Infections ◽

Central Line ◽

Pediatric Cancer Patients ◽

Lock Therapy

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Systematic Review of Health Literacy in Childhood Cancer Patients, Survivors, and Their Caregivers

Journal of Pediatric Psychology ◽

10.1093/jpepsy/jsaa009 ◽

2020 ◽

Vol 45 (4) ◽

pp. 373-385

Author(s):

Courtney Lynn ◽

Lauren Quast ◽

Hannah Rogers ◽

Karen Effinger ◽

Jordan Gilleland-Marchak

Keyword(s):

Systematic Review ◽

Health Literacy ◽

Health Outcomes ◽

Childhood Cancer ◽

Cancer Patients ◽

Cochrane Library ◽

Adequate Health Literacy ◽

Pediatric Cancer Patients ◽

Demographic Correlates ◽

The Impact

Abstract Objective This systematic review examined the literature regarding health literacy among pediatric cancer patients, survivors, and their caregivers. Specific aims were to identify and summarize measures used, levels of and demographic correlates of health literacy, effects of health literacy interventions, and associations between health literacy and health outcomes. Methods The search strategy was executed in the following databases: PubMed, EMBASE, PsycINFO, CINAHL, ERIC, and the Cochrane Library. Of the 842 unique studies retrieved, 9 met the inclusion criteria and were included in the systematic review. Results Studies used a variety of validated and study-specific measures with no measure emerging as the standard. Levels of health literacy were typically assessed subjectively and across studies the majority of those sampled self-reported adequate health literacy. Few studies examined demographic correlates of health literacy, precluding the identification of consistent predictors. Health literacy intervention research for this population is in its infancy and only pilot projects were identified; effects could not be evaluated. No studies assessed the impact of health literacy on health outcomes. Conclusions Very few studies assessed health literacy in pediatric oncology. As treatment for childhood cancer becomes increasingly complex, and patients and caregivers are expected to have adequate understanding of health information, health literacy is a critical construct that should not be overlooked.

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