Reduced Exercise Linked to Neurocognitive Deficits in ALL Survivors

Exercise intolerance may be related to neurocognitive deficits in acute lymphocytic leukemia (ALL) survivors, according to research published in Cancer.

The study included 341 adult survivors of pediatric ALL (median age, 28.5 years) and 288 controls (median age, 32.2 years) who underwent cardiopulmonary exercise testing, a two‐hour standardized neuropsychological assessment, and self‐reported questionnaires.

Multivariable modeling was used to test the association between oxygen uptake at 85% estimated heart rate (rpkVO₂) and neuropsychological test and self‐reported questionnaire domains, after adjusting for sex, age at diagnosis, cranial radiation, anthracycline and methotrexate exposure, and tobacco smoking status.

Worse exercise tolerance for ALL survivors

ALL survivors had lower mean rpkVO₂ measurements than controls (23.45 mL/kg/min vs. 33.03 mL/kg/min; P<0.001). There was also a significant difference in the median time to reach 85% predicted heart rate between survivors (12.3 minutes) and controls (10.7 minutes; P<0.001).

ALL survivors also performed worse on verbal intelligence, focused attention, verbal fluency, working memory, dominant/non-dominant motor speed, visual‐motor speed, memory span, and reading and math measures (P<0.001 for all).

Among ALL survivors, exercise intolerance was associated with decreased verbal ability, focused attention, verbal fluency, working memory, dominant motor speed, non-dominant motor speed, visual‐motor speed, memory span, reading academics, and math academics performance.

“Research is needed to determine whether interventions that improve exercise tolerance impact neurocognitive function in ALL survivors,” the authors concluded.