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Results summary of St. Jude clinical trial: 



Physical Activity to Modify Sequelae and Quality of Life in Childhood Acute Lymphoblastic Leukemia (PAQOL)

Why was this study done?

Children with acute lymphoblastic leukemia (ALL) are at risk for problems with their bones, muscles, nerves and heart. These problems can affect their quality of life. We wanted to find out if exercise or physical activity could prevent or improve these health problems in newly diagnosed patients.

The study’s main goals were to:

  • Learn whether a physical activity program could improve the patients’ strength, flexibility, endurance and bone density
  • Find out whether quality of life, physical function and bone density are affected by changes in motivation and feelings about things going on in their lives
  • Look at how gender, age, family income and parent’s education affect the patients’ physical function, bone density and health-related quality of life

When was this study done?

The study opened in November 2009 and closed in May 2015.

What did the study consist of?

Each child took part in the study for about 2.5 years. Patients were randomly assigned to one of two groups. Some received a broader and more detailed exercise program. Others received a more focused exercise program.

The patients:

  • Had scans to measure their bone strength  
  • Received home exercise programs to do about five times a week
  • Completed activity diaries
  • Wore accelerometers three times for seven days each time. These small monitors are worn on the upper arm to measure activity levels.
  • Met regularly with a physical therapist and a nurse
  • Had tests of joint flexibility, muscle strength, balance, coordination. Clinicians also timed the distance patients could walk in six minutes.   
  • Completed four surveys about their health, exercise and feelings.

The parent or guardian also completed a questionnaire four times.

What did we learn from this study?

Patients must spend two to three years in therapy during important developmental periods. Children with newly diagnosed ALL had problems with bone density, body composition, strength and fitness. To improve their quality of life, the children should begin right away on a program that includes strength exercises and aerobic conditioning. This will help prevent bone loss and preserve muscle mass.

Children with acute leukemia were also more likely to be overweight than their healthy peers. To have the most impact, these patients should begin nutrition and physical activity discussions, counseling and interventions soon after treatment begins.

What are the next research steps as a result of this study?

Scientists will continue to study ways to improve the health-related quality of life for children receiving cancer treatment.

How does this study affect my child?

Every childhood cancer survivor should receive long-term follow-up care. Through the St. Jude After Completion of Care clinic, your child will receive information and guidance for care after treatment. Please speak with your St. Jude doctor about specific guidelines that apply to your child.

For more information

Please talk with your child’s St. Jude doctor about questions or concerns you have as a result of this study.

Publications generated from this study:

Skeletal, neuromuscular and fitness impairments among children with newly diagnosed acute lymphoblastic leukemia. Ness KK, Kaste SC, Zhu L, Pui CH, Jeha S, Nathan PC, Inaba H, Wasilewski-Masker K, Shah D, Wells RJ, Karlage RE, Robison LL, Cox CL. Leuk Lymphoma. 2015 Apr;56(4):1004-11.