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

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  1. Sarfati, D., Koczwara, B. & Jackson, C. The impact of comorbidity on cancer and its treatment. CA: A Cancer J. Clin. 66, 337–350 (2016).

    Google Scholar 

  2. Lemay, V. et al. Prevention of long-term adverse health outcomes with cardiorespiratory fitness and physical activity in childhood acute lymphoblastic leukemia survivors. J. Pediatr. Hematol. Oncol. 41, e450–e458 (2019).

    Article  PubMed  Google Scholar 

  3. Caru, M. et al. Doxorubicin treatments induce significant changes on the cardiac autonomic nervous system in childhood acute lymphoblastic leukemia long-term survivors. Clin. Res. Cardiol. 108, 1000–1008 (2019).

    Article  CAS  PubMed  Google Scholar 

  4. Gavotto, A. et al. Impaired aerobic capacity in adolescents and young adults after treatment for cancer or non-malignant haematological disease. Pediatr. Res. (2023). Online ahead of print.

  5. Jarvela, L. S. et al. Physical activity and fitness in adolescent and young adult long-term survivors of childhood acute lymphoblastic leukaemia. J. Cancer Survivorship Res. Pract. 4, 339–345 (2010).

    Article  Google Scholar 

  6. Caru, M. et al. Childhood acute lymphoblastic leukemia survivors have a substantially lower cardiorespiratory fitness level than healthy canadians despite a clinically equivalent level of physical activity. J. Adolesc. Young Adult Oncol. 8, 674–683 (2019).

    Article  PubMed  Google Scholar 

  7. Takken, T. et al. Cardiopulmonary exercise testing in congenital heart disease: equipment and test protocols. Neth. Heart J. 17, 339–344 (2009).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Caru, M. et al. Maximal cardiopulmonary exercise testing in childhood acute lymphoblastic leukemia survivors exposed to chemotherapy. Support Care Cancer 29, 987–996 (2020).

  9. Klika, R., Tamburini, A., Galanti, G., Mascherini, G. & Stefani, L. The role of exercise in pediatric and adolescent cancers: a review of assessments and suggestions for clinical implementation. J. Funct. Morphol. Kinesiol. 3, 1–19 (2018).

    Google Scholar 

  10. Godfrey, S., Davies, C. T., Wozniak, E. & Barnes, C. A. Cardio-respiratory response to exercise in normal children. Clin. Sci. 40, 419–431 (1971).

    Article  CAS  PubMed  Google Scholar 

  11. Godfrey, S. Exercise testing in children: applications in health and disease 12-41 (Saunders Company Ltd, 1974).

  12. Kowaluk, A. & Woźniewski, M. Peak oxygen uptake and exercise capacity of children undergoing leukemia treatment. Int. J. Environ. Res. Public Health 17, 8732 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  13. Nielsen, M. K. F. et al. Effects of a physical activity program from diagnosis on cardiorespiratory fitness in children with cancer: a national non-randomized controlled trial. BMC Med. 18, 175 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  14. Thorsteinsson, T. et al. Study protocol: rehabilitation including social and physical activity and education in children and teenagers with cancer (respect). BMC Cancer 13, 544 (2013).

    Article  PubMed  PubMed Central  Google Scholar 

  15. Atkinson, M. et al. A randomized controlled trial of a structured exercise intervention after the completion of acute cancer treatment in adolescents and young adults. Pediatr. Bood Cancer 68, e28751 (2021).

    Google Scholar 

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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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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).

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