Musculoskeletal impairments in children receiving intensive therapy for acute leukemia or undergoing hematopoietic stem cell transplant: A report from the Children's Oncology Group.

TitleMusculoskeletal impairments in children receiving intensive therapy for acute leukemia or undergoing hematopoietic stem cell transplant: A report from the Children's Oncology Group.
Publication TypeJournal Article
Year of Publication2021
AuthorsThompson J, Fisher B, Sung L, Dvorak C, Dang H, Lo T, Alexander S
JournalPediatr Blood Cancer
Paginatione29053
Date Published2021 Apr 23
ISSN1545-5017
Abstract

BACKGROUND: Children receiving intensive chemotherapy for leukemia or undergoing hematopoietic stem cell transplant (HSCT) for solid tumors or leukemia are at risk for musculoskeletal (MSK) impairment from their underlying disease and from treatment. Data are limited on the incidence and nature of these disorders during intensive therapy. This study's objective was to provide a cross-sectional description of MSK impairments in this population.

PROCEDURE: Children with acute myeloid leukemia (AML), relapsed acute lymphoblastic leukemia (rALL), or undergoing HSCT were systematically assessed for MSK impairments as part of Children's Oncology Group study ACCL0934. Assessments occurred at study entry, at 2 months, and at 12 months and included evaluation for signs or symptoms of MSK impairment and the type, site, and diagnosis.

RESULTS: Six hundred three patients were included. MSK signs or symptoms were present in 48 (8.0%) children at study entry, 64 (13.5%) children at 2 months, and 40 (11.6%) children at 12 months. Arthralgia and/or gait abnormalities were the most common impairments; the knee was the most common site. Arthritis and tendonitis were both rare. Vincristine neuropathy, MSK impacts from central nervous system pathology, and bone or joint pain from underlying cancer were the most common diagnoses. Multivariate analysis demonstrated that having rALL (odds ratio [OR] 2.00, 95% CI 1.07-3.76, p = .03) or obesity (OR 2.10, 95% CI 1.12-3.95, p = .02) were risk factors for MSK impairment at study entry.

CONCLUSIONS: MSK impairments are common in this intensively treated patient population, especially in those with rALL and those who are obese.

DOI10.1002/pbc.29053
Alternate JournalPediatr Blood Cancer
PubMed ID33890409
Grant ListUG1CA189955 / / National Cancer Institute Community Oncology Research Program /
U10CA095861 / / National Cancer Institute Community Oncology Research Program Research Base Grant (awarded to the Children's Oncology Group) /