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  • Clinical Research Article
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Impaired aerobic capacity in adolescents and young adults after treatment for cancer or non-malignant haematological disease

Pediatric Research volume 94, pages 626–631 (2023)Cite this article

Abstract

Purpose

Childhood cancer survivors are at increased risk for cardiovascular disease. Maximal oxygen uptake (VO2max) is a major determinant of cardiovascular morbidity. The aim of this study was to compare aerobic capacity, measured by cardiopulmonary exercise test (CPET), of adolescents and young adults in remission with that of healthy controls and to identify the predictors of aerobic capacity in this population.

Method

This is a controlled cross-sectional study.

Results

A total of 477 subjects (77 in remission and 400 controls), aged from 6 to 25 years, were included, with a mean delay between end of treatment and CPET of 2.9 ± 2.3 years in the remission group. In this group, the mean VO2max was significantly lower than in controls (37.3 ± 7.6 vs. 43.3 ± 13.1 mL/kg/min, P < 0.01, respectively), without any clinical or echocardiographic evidence of heart failure. The VAT was significantly lower in the remission group (26.9 ± 6.0 mL/kg/min vs. 31.0 ± 9.9 mL/kg/min, P < 0.01, respectively). A lower VO2max was associated with female sex, older age, higher BMI, radiotherapy, and hematopoietic stem cell transplantation.

Conclusion

Impaired aerobic capacity had a higher prevalence in adolescents and young adults in cancer remission. This impairment was primarily related to physical deconditioning and not to heart failure.

Trial registry

NCT04815447.

Impact

  • In childhood cancer survivors, aerobic capacity is five times more impaired than in healthy subjects.

  • This impairment mostly reflects early onset of physical deconditioning.

  • No evidence of heart failure was observed in this population.

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Fig. 1: Percent-predicted VO2max and VAT in the remission group and in healthy controls.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Author information

Authors and Affiliations

  1. Paediatric Cardiology and Pulmonology Unit, Department of Paediatrics, Montpellier University Hospital, Montpellier, France

    Arthur Gavotto, Vincent Dubard, Hamouda Abassi, Sophie Guillaumont, Gregoire De La Villeon, Anne Requirand & Stefan Matecki

  2. PhyMedExp, CNRS, INSERM, University of Montpellier, Montpellier, France

    Arthur Gavotto & Stefan Matecki

  3. Paediatric and Congenital Cardiology Department, M3C National Reference Centre, Bordeaux University Hospital, Bordeaux, France

    Martina Avesani & Pascal Amedro

  4. Epidemiology and Clinical Research Department, Clinical Investigation Centre, INSERM-CIC 1411, University of Montpellier, Montpellier University Hospital, Montpellier, France

    Helena Huguet & Marie-Christine Picot

  5. Paediatric Cardiology and Rehabilitation Centre, Saint-Pierre Institute, Palavas-Les-Flots, France

    Sophie Guillaumont & Gregoire De La Villeon

  6. Paediatric Cancer Unit, Department of Paediatrics, Montpellier University Hospital, Montpellier, France

    Stephanie Haouy, Nicolas Sirvent, Anne Sirvent & Alexandre Theron

  7. IHU Liryc, INSERM 1045, Bordeaux University, Bordeaux, France

    Pascal Amedro

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Contributions

Study conception and design: A.G. and P.A. Acquisition of data: A.G. and V.D. Analysis and interpretation of data: A.G., V.D., H.H., M.-C.P., S.G., S.H., N.S., A.S., S.M. and P.A. Drafting the article: A.G., V.D., M.A. and P.A. Critical revising of the article for important intellectual content: all authors. Final approval of the version to be published: all authors. Study supervision: P.A.

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Correspondence to Pascal Amedro.

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Gavotto, A., Dubard, V., Avesani, M. et al. Impaired aerobic capacity in adolescents and young adults after treatment for cancer or non-malignant haematological disease. Pediatr Res 94, 626–631 (2023). https://doi.org/10.1038/s41390-023-02477-6

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