Nissen Anne, Gerbek Tina, Fogelstrøm Kathrine, Schmidt-Andersen Peter, Sørensen Kaspar, Mackey Abigail Louise, Fridh Martin Kaj, Müller Klaus
Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Pediatr Blood Cancer. 2025 Jun;72(6):e31684. doi: 10.1002/pbc.31684. Epub 2025 Mar 30.
We examined cardiorespiratory fitness and physical performance in long-term survivors of paediatric haematopoietic stem cell transplantation (HSCT) and explored how these are associated with the presence of metabolic syndrome (MetS).
We included 90 survivors of paediatric HSCT (median age, 30.3 years; range, 19.6-53.0; median follow-up time, 20.2 years) and 32 healthy controls. Cardiorespiratory fitness was evaluated by cardiopulmonary exercise tests, and physical performance was assessed through sit-to-stand, handgrip strength, timed-up-and-go, walking pace and six-minute walk tests. We assessed for components of MetS (blood pressure, waist circumference, plasma lipids, and glucose). For comparison of physical capacity between survivors and controls and survivors with or without the presence of MetS, a multiple linear regression analysis corrected for age and sex was applied.
Survivors demonstrated lower cardiorespiratory fitness compared with controls (mean ± SD VO peak 29.3 ± 7.0 mL/kg/min vs. 44.3 ± 6.8 mL/kg/min, p < 0.0001) and impairment in all physical performance outcomes, where the most prominent differences compared with controls were seen in the sit-to-stand test (33% reduction). Twenty-eight percent of survivors fulfilled the criteria for MetS. The presence of MetS associated with lower VO peak (p = 0.03), poorer outcomes in the six-minute walk test (p = 0.02), walking pace (p = 0.03) and the timed-up-and-go test (p = 0.003).
Young adult survivors of paediatric HSCT are at risk of markedly reduced physical capacity compared with age- and sex-matched controls, and the high incidence of MetS observed among survivors was associated with this impairment. Overall, these data underline the importance of monitoring physical capacity in survivors of paediatric HSCT.
我们研究了儿童造血干细胞移植（HSCT）长期存活者的心肺适能和身体机能，并探讨了这些因素与代谢综合征（MetS）存在情况之间的关联。
我们纳入了90名儿童HSCT存活者（中位年龄30.3岁；范围19.6 - 53.0岁；中位随访时间20.2年）和32名健康对照者。通过心肺运动试验评估心肺适能，通过坐立试验、握力、计时起立行走、步行速度和六分钟步行试验评估身体机能。我们评估了MetS的各项组成部分（血压、腰围、血脂和血糖）。为比较存活者与对照者以及有或无MetS的存活者之间的身体能力，应用了校正年龄和性别的多元线性回归分析。
与对照者相比，存活者表现出较低的心肺适能（平均±标准差VO峰值29.3±7.0 mL/kg/min对44.3±6.8 mL/kg/min，p < 0.0001），并且在所有身体机能指标上均有损害，其中与对照者相比最显著的差异出现在坐立试验中（降低了33%）。28%的存活者符合MetS标准。MetS的存在与较低的VO峰值相关（p = 0.03），在六分钟步行试验（p = 0.02）、步行速度（p = 0.03）和计时起立行走试验（p = 0.003）中的结果较差。
与年龄和性别匹配的对照者相比，儿童HSCT的年轻成年存活者存在身体能力显著下降的风险，并且在存活者中观察到的MetS高发病率与这种损害相关。总体而言，这些数据强调了监测儿童HSCT存活者身体能力的重要性。
