Prospective Evaluation of Cardiorespiratory Fitness After Hematopoietic Stem Cell Transplantation in Children.

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Pulmonology Pub Date : 2025-05-01 DOI:10.1002/ppul.70994

Véronique Houdouin, Hala Feghali, Sophie Boileau, Michel Guinot, Philippe Reix, Justine Pages, Sophie Guilmin Crepon, Christophe Delclaux

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Abstract

Allogeneic hematopoietic stem cell transplantation (HSCT) is associated with long-term sequelae such as reduced exercise capacity, but whether some degree of spontaneous recovery occurs during childhood is yet to be determined. This prospective multicenter study aimed to evaluate exercise capacity at 1 and 3 years after HSCT. Forty-four (30 males, median age [interquartile] 13.0 years [10.5; 15.4] at first cardiopulmonary exercise test [CPET]) of the 292 children included in the RESPPEDHEM cohort had a CPET at both time points. Their median z-score of peak V'O₂ did not significantly improve between the two CPETs: -2.7 (-4.0; -1.5) at 1 year versus -2.2 (-3.1; -0.6) at 3 years, p = 0.09. It was associated with a low z-score of peak oxygen pulse: -2.2 (-3.6; -0.9) versus -1.9 (-2.8; -0.9), p = 0.14, suggesting low muscular fitness. Female sex was associated with a higher risk of low muscular fitness, whereas the Play-Performance Scale (PPS) was unable to differentiate between adolescents with or without low fitness (37/39 adolescents had a PPS score evaluated by their parents of 100 and were judged as fully active and normal, contrasting with the results of their CPET). In conclusion, impaired exercise capacity is present one1 year after HSCT, does not improve after two subsequent years in adolescents, and is under-evaluated by their parents. CLINICALTRIALS.GOV IDENTIFIER: NCT02032381.

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儿童造血干细胞移植后心肺健康的前瞻性评价。

同种异体造血干细胞移植（HSCT）与运动能力降低等长期后遗症有关，但儿童时期是否会出现一定程度的自发恢复尚不确定。这项前瞻性多中心研究旨在评估HSCT后1年和3年的运动能力。44例(男性30例，中位年龄[四分位数间]13.0岁[10.5；15.4] RESPPEDHEM队列中纳入的292名儿童在第一次心肺运动试验[CPET]时在两个时间点都有CPET。他们的峰值V'O2中位数z分在两个cpet之间没有显著改善：-2.7 (-4.0；-1.5)与-2.2 (-3.1；-0.6), p = 0.09。它与低的峰值氧脉冲z分数相关：-2.2 (-3.6；-0.9) vs -1.9 (-2.8；-0.9), p = 0.14，说明肌肉适合度较低。女性与肌肉适应度低的风险较高相关，而游戏-表现量表（PPS）无法区分青少年是否具有低适应度（37/39的青少年的PPS得分由父母评估为100，与他们的CPET结果相比，被认为是完全活跃和正常的）。总之，青少年的运动能力受损在移植后1年出现，在随后的2年后没有改善，并且被父母低估了。临床试验。政府标识符：nct02032381。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Pulmonology 医学-呼吸系统

CiteScore

6.00

自引率

12.90%

发文量

468

审稿时长

3-8 weeks

期刊介绍： Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases. PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.