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The importance of cardiopulmonary exercise test to improve supportive care in adolescent and young adult survivors of childhood cancer

Pediatric Research volume 94, pages 850–851 (2023)Cite this article

Patients’ exposure to treatment for cancer (chemotherapy, radiotherapy, hematopoietic graft) and non-malignant pediatric hematological disease often leads to several long-term adverse events affecting their health.1 The management of these long-term symptoms (e.g., cardiac function, pulmonary and muscle function) is challenging and can be exacerbated in cases of impaired aerobic capacity.2,3 Nevertheless, it appears that routine assessments of aerobic capacity in the pediatric cardio-oncology field are not systematically performed. Related to this topic, we read with interest the cross-sectional controlled study published in the Pediatric Research journal by Gavotto et al.4.

The purpose of the authors’ work was to compare the aerobic capacity of adolescent and young adult (AYA) survivors of childhood cancer to age- and sex-matched healthy controls. To reach their goal, they recruited 77 AYA survivors of childhood cancer and 400 healthy controls. As described in their limitations section, AYA survivors of childhood cancer were referred by pediatric oncologists and the authors recognized that the oncologists may have referred the most severe patients for cardiopulmonary exercise test (CPET) assessment. Participants in the control group were initially approached because they had a consultation for a non-severe functional symptom linked to exercise (murmur, palpitation, or dyspnea) or for a medical sports certificate at the hospital. Although a complete normal check-up was reported to be obtained before undergoing the study procedure, the authors agree that they might not be considered healthy participants. All participants underwent a maximal CPET on a cycle ergometer and the authors accurately described their maximality criteria and the measured parameters.

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Funding

Funding

M.C. is supported by the Four Diamonds Research Funds, Department of Pediatrics, Division of Hematology and Oncology, Penn State University College of Medicine. J.H. is supported by the Cancer Assistance and Resource Education (CARE) Center at Penn State Cancer Institute, Penn State Milton S. Hershey Medical Center.

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Authors and Affiliations

  1. Department of Pediatric, Division of Hematology and Oncology, Pennsylvania State University College of Medicine, Hershey, PA, USA

    Maxime Caru

  2. Public Health Science, Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA, USA

    Jared Heitzenrater

  3. Division of Hematology and Oncology, University of Pittsburgh, Pittsburgh, PA, USA

    Kathryn H. Schmitz

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  1. Maxime Caru
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  2. Jared Heitzenrater
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  3. Kathryn H. Schmitz
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All authors made substantial contributions to the interpretation of the data; AND wrote or revised the manuscript for important intellectual content; AND provided final approval of the version to be published.

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Correspondence to Maxime Caru.

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Caru, M., Heitzenrater, J. & Schmitz, K.H. The importance of cardiopulmonary exercise test to improve supportive care in adolescent and young adult survivors of childhood cancer. Pediatr Res 94, 850–851 (2023). https://doi.org/10.1038/s41390-023-02569-3

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