Exercise in Pediatric Cancer Patients

  • Luisa Soares-Miranda
  • Carmen Fiuza-Luces
  • Alejandro Lucia
Part of the Energy Balance and Cancer book series (EBAC, volume 6)


Physical activity (PA) programs are starting to emerge as beneficial ­during and after pediatric cancer treatment. Current evidence suggests that the bed rest traditionally recommended for child cancer patients could aggravate some of the side effects of treatments, particularly loss of physical function and muscle strength. In contrast, regular PA seems to play an important role in preventing, attenuating, and rehabilitating the mid- and long-term adverse effects of cancer treatment. In this chapter we review the main cancers that affect children, their treatments and side-effects, and describe the main findings of studies addressing the benefits of exercise interventions and their safety. Special attention is paid to acute lymphocytic leukemia as the most common childhood cancer and the most widely explored in terms of exercise research.


Physical Activity Acute Lymphoblastic Leukemia Hematopoietic Stem Cell Transplant Soft Tissue Sarcoma Childhood Cancer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Luisa Soares-Miranda is supported by the Portuguese Foundation for Science and Technology SFRH/BPD/76947/2011.


  1. 1.
    Jemal A, Siegel R, Xu J, Ward E (2010) Cancer Statistics, 2010. CA Cancer J Clin 60:277–300PubMedCrossRefGoogle Scholar
  2. 2.
    Robbins SL, Kumar V, Cotran RS (2010) Robbins and cotran pathologic basis of disease. Saunders/Elsevier, PhiladelphiaGoogle Scholar
  3. 3.
    Kenney LB, Bradeen H, Kadan-Lottick NS, Diller L, Homans A, Schwartz CL (2011) The ­current status of follow-up services for childhood cancer survivors, are we meeting goals and expectations: a report from the Consortium for New England Childhood Cancer Survivors. Pediatr Blood Cancer 57:1062–1066PubMedCrossRefGoogle Scholar
  4. 4.
    Huang TT, Ness KK (2011) Exercise interventions in children with cancer: a review. Int J Pediatr 2011:461512PubMedGoogle Scholar
  5. 5.
    Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, Friedman DL, Marina N, Hobbie W, Kadan-Lottick NS, Schwartz CL, Leisenring W, Robison LL (2006) Chronic health conditions in adult survivors of childhood cancer. N Engl J Med 355:1572–1582PubMedCrossRefGoogle Scholar
  6. 6.
    Courneya KS, Friedenreich CM (2001) Framework peace: an organizational model for ­examining physical exercise across the cancer experience. Ann Behav Med 23:263–272PubMedCrossRefGoogle Scholar
  7. 7.
    Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvao DA, Pinto BM, Irwin ML, Wolin KY, Segal RJ, Lucia A, Schneider CM, von Gruenigen VE, Schwartz AL (2010) American college of sports medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 42:1409–1426PubMedCrossRefGoogle Scholar
  8. 8.
    Strong WB, Malina RM, Blimkie CJ, Daniels SR, Dishman RK, Gutin B, Hergenroeder AC, Must A, Nixon PA, Pivarnik JM, Rowland T, Trost S, Trudeau F (2005) Evidence based ­physical activity for school-age youth. J Pediatr 146:732–737PubMedCrossRefGoogle Scholar
  9. 9.
    (2008) Harrison’s principles of internal medicine. The McGraw-Hill, New YorkGoogle Scholar
  10. 10.
    Turner-Gomes SO, Lands LC, Halton J, Hanning RM, Heigenhauser GJ, Pai M, Barr R (1996) Cardiorespiratory status after treatment for acute lymphoblastic leukemia. Med Pediatr Oncol 26:160–165PubMedCrossRefGoogle Scholar
  11. 11.
    Felder-Puig R, di Gallo A, Waldenmair M, Norden P, Winter A, Gadner H, Topf R (2006) Health-related quality of life of pediatric patients receiving allogeneic stem cell or bone ­marrow transplantation: results of a longitudinal, multi-center study. Bone Marrow Transplant 38:119–126PubMedCrossRefGoogle Scholar
  12. 12.
    Duggan C, Bechard L, Donovan K, Vangel M, O’Leary A, Holmes C, Lehmann L, Guinan E (2003) Changes in resting energy expenditure among children undergoing allogeneic stem cell transplantation. Am J Clin Nutr 78:104–109PubMedGoogle Scholar
  13. 13.
    White AC, Terrin N, Miller KB, Ryan HF (2005) Impaired respiratory and skeletal muscle strength in patients prior to hematopoietic stem-cell transplantation. Chest 128:145–152PubMedCrossRefGoogle Scholar
  14. 14.
    Wiskemann J, Huber G (2008) Physical exercise as adjuvant therapy for patients undergoing hematopoietic stem cell transplantation. Bone Marrow Transplant 41:321–329PubMedCrossRefGoogle Scholar
  15. 15.
    Courneya KS, Friedenreich CM (2011) Physical activity and cancer: an introduction. Recent Results Cancer Res 186:1–10PubMedCrossRefGoogle Scholar
  16. 16.
    Chabner BA, Thomas J, Lynch J, Longo DL (2008) Harrisson’s manual of oncology. McGraw Hill, New YorkGoogle Scholar
  17. 17.
    National Cancer Institute (2010) United States of America. Http://www.Cancer.Gov/ statistical data obtained from: Http://www.Seer.Cancer.Gov/ and www.Seer.Gov/csr/1975-2006/results_merged/sect_28childhood_cancer.Pdf. Accessed Feb 2010
  18. 18.
    Pieters R, Carroll WL (2008) Biology and treatment of acute lymphoblastic leukemia. Pediatr Clin North Am 55:1–20, ixPubMedCrossRefGoogle Scholar
  19. 19.
    Fauci A, Kasper D, Braunwald E, Hauser S, Longo D, Jameson J (2008) Harrison’s principles of internal medicine, 17th edn. McGraw-Hill, New YorkGoogle Scholar
  20. 20.
    Pui CH, Evans WE (2006) Treatment of acute lymphoblastic leukemia. N Engl J Med 354:166–178PubMedCrossRefGoogle Scholar
  21. 21.
    LeClerc JM, Billett AL, Gelber RD, Dalton V, Tarbell N, Lipton JM, Barr R, Clavell LA, Asselin B, Hurwitz C, Schorin M, Lipshultz SE, Declerck L, Silverman LB, Cohen HJ, Sallan SE (2002) Treatment of childhood acute lymphoblastic leukemia: results of Dana-Farber all consortium protocol 87–01. J Clin Oncol 20:237–246PubMedCrossRefGoogle Scholar
  22. 22.
    Mahoney DH Jr, Shuster JJ, Nitschke R, Lauer S, Steuber CP, Camitta B (2000) Intensification with intermediate-dose intravenous methotrexate is effective therapy for children with lower-risk b-precursor acute lymphoblastic leukemia: a pediatric oncology group study. J Clin Oncol 18:1285–1294PubMedGoogle Scholar
  23. 23.
    Schrappe M, Reiter A, Ludwig WD, Harbott J, Zimmermann M, Hiddemann W, Niemeyer C, Henze G, Feldges A, Zintl F, Kornhuber B, Ritter J, Welte K, Gadner H, Riehm H (2000) Improved outcome in childhood acute lymphoblastic leukemia despite reduced use of anthracyclines and cranial radiotherapy: results of trial all-bfm 90. German-Austrian-Swiss all-bfm study group. Blood 95:3310–3322PubMedGoogle Scholar
  24. 24.
    Richards S, Burrett J, Hann I, Chessells J, Hill F, Bailey C (1998) Improved survival with early intensification: combined results from the medical research council childhood all randomised trials, ukall x and ukall xi. Medical research council working party on childhood leukaemia. Leukemia 12:1031–1036PubMedCrossRefGoogle Scholar
  25. 25.
    Silverman LB, Gelber RD, Dalton VK, Asselin BL, Barr RD, Clavell LA, Hurwitz CA, Moghrabi A, Samson Y, Schorin MA, Arkin S, Declerck L, Cohen HJ, Sallan SE (2001) Improved outcome for children with acute lymphoblastic leukemia: results of Dana-Farber consortium protocol 91–01. Blood 97:1211–1218PubMedCrossRefGoogle Scholar
  26. 26.
    Rizzari C, Valsecchi MG, Arico M, Conter V, Testi A, Barisone E, Casale F, Lo Nigro L, Rondelli R, Basso G, Santoro N, Masera G (2001) Effect of protracted high-dose l-asparaginase given as a second exposure in a Berlin-Frankfurt-Munster-based treatment: results of the randomized 9102 intermediate-risk childhood acute lymphoblastic leukemia study – a report from the associazione italiana ematologia oncologia pediatric. J Clin Oncol 19:1297–1303PubMedGoogle Scholar
  27. 27.
    Kaspers GJ, Creutzig U (2005) Pediatric acute myeloid leukemia: international progress and future directions. Leukemia 19:2025–2029PubMedCrossRefGoogle Scholar
  28. 28.
    Tallman MS, Hakimian D, Kwaan HC, Rickles FR (1993) New insights into the pathogenesis of coagulation dysfunction in acute promyelocytic leukemia. Leuk Lymphoma 11:27–36PubMedCrossRefGoogle Scholar
  29. 29.
    Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ (2009) Cancer Statistics, 2009. CA Cancer J Clin 59:225–249PubMedCrossRefGoogle Scholar
  30. 30.
    Matsutani M, Sano K, Takakura K, Fujimaki T, Nakamura O, Funata N, Seto T (1997) Primary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases. J Neurosurg 86:446–455PubMedCrossRefGoogle Scholar
  31. 31.
    Ferrari S, Briccoli A, Mercuri M, Bertoni F, Cesari M, Longhi A, Bacci G (2006) Late relapse in osteosarcoma. J Pediatr Hematol Oncol 28:418–422PubMedCrossRefGoogle Scholar
  32. 32.
    Suit H, Spiro I (1995) Radiation as a therapeutic modality in sarcomas of the soft tissue. Hematol Oncol Clin North Am 9:733–746PubMedGoogle Scholar
  33. 33.
    Pratt CB, Pappo AS, Gieser P, Jenkins JJ, Salzbergdagger A, Neff J, Rao B, Green D, Thomas P, Marcus R, Parham D, Maurer H (1999) Role of adjuvant chemotherapy in the treatment of surgically resected pediatric nonrhabdomyosarcomatous soft tissue sarcomas: a pediatric oncology group study. J Clin Oncol 17(4):1219PubMedGoogle Scholar
  34. 34.
    Neville H, Corpron C, Blakely ML, Andrassy R (2003) Pediatric neurofibrosarcoma. J Pediatr Surg 38:343–346, discussion 343–346PubMedCrossRefGoogle Scholar
  35. 35.
    Green DM (2004) The treatment of stages i–iv favorable histology Wilms’ tumor. J Clin Oncol 22:1366–1372PubMedCrossRefGoogle Scholar
  36. 36.
    Sandlund JT, Downing JR, Crist WM (1996) Non-Hodgkin’s lymphoma in childhood. N Engl J Med 334:1238–1248PubMedCrossRefGoogle Scholar
  37. 37.
    Cairo MS, Gerrard M, Sposto R, Auperin A, Pinkerton CR, Michon J, Weston C, Perkins SL, Raphael M, McCarthy K, Patte C (2007) Results of a randomized international study of high-risk central nervous system b non-Hodgkin lymphoma and b acute lymphoblastic leukemia in children and adolescents. Blood 109:2736–2743PubMedGoogle Scholar
  38. 38.
    Salzburg J, Burkhardt B, Zimmermann M, Wachowski O, Woessmann W, Oschlies I, Klapper W, Wacker HH, Ludwig WD, Niggli F, Mann G, Gadner H, Riehm H, Schrappe M, Reiter A (2007) Prevalence, clinical pattern, and outcome of CNS involvement in childhood and adolescent non-Hodgkin’s lymphoma differ by non-Hodgkin’s lymphoma subtype: a Berlin-Frankfurt-Munster group report. J Clin Oncol 25:3915–3922PubMedCrossRefGoogle Scholar
  39. 39.
    Link MP, Shuster JJ, Donaldson SS, Berard CW, Murphy SB (1997) Treatment of children and young adults with early-stage non-Hodgkin’s lymphoma. N Engl J Med 337:1259–1266PubMedCrossRefGoogle Scholar
  40. 40.
    Patte C, Auperin A, Gerrard M, Michon J, Pinkerton R, Sposto R, Weston C, Raphael M, Perkins SL, McCarthy K, Cairo MS (2007) Results of the randomized international fab/lmb96 trial for intermediate risk b-cell non-Hodgkin lymphoma in children and adolescents: It is ­possible to reduce treatment for the early responding patients. Blood 109:2773–2780PubMedGoogle Scholar
  41. 41.
    Lucia A, Earnest C, Perez M (2003) Cancer-related fatigue: can exercise physiology assist oncologists? Lancet Oncol 4:616–625PubMedCrossRefGoogle Scholar
  42. 42.
    American Academy of Pediatrics (2009) Long-term follow-up care for pediatric cancer survivors. Pediatrics 123:906–915CrossRefGoogle Scholar
  43. 43.
    Chinapaw MJ, Buffart LM, van Mechelen W, Schep G, Aaronson NK, van Harten WH, Stuiver MM, Kersten MJ, Nollet F, Kaspers GJ, van Dulmen-den Broeder E, Huisman J, Takken T, van Tulder M, Brug J (2011) Alpe d’huzes cancer rehabilitation (a-care) research: four randomized controlled exercise trials and economic evaluations in cancer patients and survivors. Int J Behav MedGoogle Scholar
  44. 44.
    San Juan AF, Wolin K, Lucia A (2011) Physical activity and pediatric cancer survivorship. Recent Results Cancer Res 186:319–347PubMedCrossRefGoogle Scholar
  45. 45.
    Jenney ME, Faragher EB, Jones PH, Woodcock A (1995) Lung function and exercise capacity in survivors of childhood leukaemia. Med Pediatr Oncol 24:222–230PubMedCrossRefGoogle Scholar
  46. 46.
    Matthys D, Verhaaren H, Benoit Y, Laureys G, De Naeyer A, Craen M (1993) Gender difference in aerobic capacity in adolescents after cure from malignant disease in childhood. Acta Paediatr 82:459–462PubMedCrossRefGoogle Scholar
  47. 47.
    Edwards MR, Hunte GS, Belzberg AS, Sheel AW, Worsley DF, McKenzie DC (2000) Alveolar epithelial integrity in athletes with exercise-induced hypoxemia. J Appl Physiol 89:1537–1542PubMedGoogle Scholar
  48. 48.
    Florin TA, Fryer GE, Miyoshi T, Weitzman M, Mertens AC, Hudson MM, Sklar CA, Emmons K, Hinkle A, Whitton J, Stovall M, Robison LL, Oeffinger KC (2007) Physical inactivity in adult survivors of childhood acute lymphoblastic leukemia: a report from the childhood cancer survivor study. Cancer Epidemiol Biomarkers Prev 16:1356–1363PubMedCrossRefGoogle Scholar
  49. 49.
    Oeffinger KC, Buchanan GR, Eshelman DA, Denke MA, Andrews TC, Germak JA, Tomlinson GE, Snell LE, Foster BM (2001) Cardiovascular risk factors in young adult survivors of childhood acute lymphoblastic leukemia. J Pediatr Hematol Oncol 23:424–430PubMedCrossRefGoogle Scholar
  50. 50.
    Tillmann V, Darlington AS, Eiser C, Bishop NJ, Davies HA (2002) Male sex and low physical activity are associated with reduced spine bone mineral density in survivors of childhood acute lymphoblastic leukemia. J Bone Miner Res 17:1073–1080PubMedCrossRefGoogle Scholar
  51. 51.
    Warner JT, Bell W, Webb DK, Gregory JW (1997) Relationship between cardiopulmonary response to exercise and adiposity in survivors of childhood malignancy. Arch Dis Child 76:298–303PubMedCrossRefGoogle Scholar
  52. 52.
    Davies HA (1993) Late problems faced by childhood cancer survivors. Br J Hosp Med 50:137–140PubMedGoogle Scholar
  53. 53.
    Nysom K, Molgaard C, Holm K, Hertz H, Michaelsen KF (1998) Bone mass and body composition after cessation of therapy for childhood cancer. Int J Cancer Suppl 11:40–43PubMedCrossRefGoogle Scholar
  54. 54.
    Reinders-Messelink H, Schoemaker M, Snijders T, Goeken L, van Den Briel M, Bokkerink J, Kamps W (1999) Motor performance of children during treatment for acute lymphoblastic leukemia. Med Pediatr Oncol 33:545–550PubMedCrossRefGoogle Scholar
  55. 55.
    Stone PC, Minton O (2008) Cancer-related fatigue. Eur J Cancer 44:1097–1104PubMedCrossRefGoogle Scholar
  56. 56.
    Clanton NR, Klosky JL, Li C, Jain N, Srivastava DK, Mulrooney D, Zeltzer L, Stovall M, Robison LL, Krull KR (2011) Fatigue, vitality, sleep, and neurocognitive functioning in adult survivors of childhood cancer: a report from the childhood cancer survivor study. Cancer 117(11):2559–2568CrossRefGoogle Scholar
  57. 57.
    Hockenberry-Eaton M, Hinds PS, Alcoser P, O’Neill JB, Euell K, Howard V, Gattuso J, Taylor J (1998) Fatigue in children and adolescents with cancer. J Pediatr Oncol Nurs 15:172–182PubMedCrossRefGoogle Scholar
  58. 58.
    Meeske KA, Siegel SE, Globe DR, Mack WJ, Bernstein L (2005) Prevalence and correlates of fatigue in long-term survivors of childhood leukemia. J Clin Oncol 23:5501–5510PubMedCrossRefGoogle Scholar
  59. 59.
    San Juan AF, Fleck SJ, Chamorro-Vina C, Mate-Munoz JL, Moral S, Garcia-Castro J, Ramirez M, Madero L, Lucia A (2007) Early-phase adaptations to intrahospital training in strength and functional mobility of children with leukemia. J Strength Cond Res 21:173–177PubMedCrossRefGoogle Scholar
  60. 60.
    San Juan AF, Fleck SJ, Chamorro-Vina C, Mate-Munoz JL, Moral S, Perez M, Cardona C, Del Valle MF, Hernandez M, Ramirez M, Madero L, Lucia A (2007) Effects of an intrahospital exercise program intervention for children with leukemia. Med Sci Sports Exerc 39:13–21PubMedCrossRefGoogle Scholar
  61. 61.
    Keats MR, Culos-Reed SN (2008) A community-based physical activity program for adolescents with cancer (project trek): program feasibility and preliminary findings. J Pediatr Hematol Oncol 30:272–280PubMedCrossRefGoogle Scholar
  62. 62.
    Aznar S, Webster AL, San Juan AF, Chamorro-Vina C, Mate-Munoz JL, Moral S, Perez M, Garcia-Castro J, Ramirez M, Madero L, Lucia A (2006) Physical activity during treatment in children with leukemia: a pilot study. Appl Physiol Nutr Metab 31:407–413PubMedCrossRefGoogle Scholar
  63. 63.
    San Juan AF, Chamorro-Vina C, Mate-Munoz JL, Fernandez del Valle M, Cardona C, Hernandez M, Madero L, Perez M, Ramirez M, Lucia A (2008) Functional capacity of children with leukemia. Int J Sports Med 29:163–167PubMedCrossRefGoogle Scholar
  64. 64.
    van Brussel M, Takken T, Lucia A, van der Net J, Helders PJ (2005) Is physical fitness decreased in survivors of childhood leukemia? a systematic review. Leukemia 19:13–17PubMedGoogle Scholar
  65. 65.
    Reilly JJ, Ventham JC, Ralston JM, Donaldson M, Gibson B (1998) Reduced energy expenditure in preobese children treated for acute lymphoblastic leukemia. Pediatr Res 44:557–562PubMedCrossRefGoogle Scholar
  66. 66.
    Mayer EI, Reuter M, Dopfer RE, Ranke MB (2000) Energy expenditure, energy intake and prevalence of obesity after therapy for acute lymphoblastic leukemia during childhood. Horm Res 53:193–199PubMedCrossRefGoogle Scholar
  67. 67.
    Warner JT, Bell W, Webb DK, Gregory JW (1998) Daily energy expenditure and physical activity in survivors of childhood malignancy. Pediatr Res 43:607–613PubMedCrossRefGoogle Scholar
  68. 68.
    Bell W, Warner JT, Evans WD, Webb DK, Mullen RH, Gregory JW (2006) Perception of effort at low and moderate intensity exercise in survivors of childhood acute lymphoblastic ­leukaemia. Ann Hum Biol 33:357–371PubMedCrossRefGoogle Scholar
  69. 69.
    San Juan AF, Chamorro-Vina C, Moral S, Fernandez del Valle M, Madero L, Ramirez M, Perez M, Lucia A (2008) Benefits of intrahospital exercise training after pediatric bone ­marrow transplantation. Int J Sports Med 29:439–446PubMedCrossRefGoogle Scholar
  70. 70.
    van Brussel M, Takken T, van der Net J, Engelbert RH, Bierings M, Schoenmakers MA, Helders PJ (2006) Physical function and fitness in long-term survivors of childhood ­leukaemia. Pediatr Rehabil 9:267–274PubMedGoogle Scholar
  71. 71.
    Ness KK, Baker KS, Dengel DR, Youngren N, Sibley S, Mertens AC, Gurney JG (2007) Body composition, muscle strength deficits and mobility limitations in adult survivors of childhood acute lymphoblastic leukemia. Pediatr Blood Cancer 49:975–981PubMedCrossRefGoogle Scholar
  72. 72.
    Wright MJ, Halton JM, Martin RF, Barr RD (1998) Long-term gross motor performance ­following treatment for acute lymphoblastic leukemia. Med Pediatr Oncol 31:86–90PubMedCrossRefGoogle Scholar
  73. 73.
    Harz KJ, Muller HL, Waldeck E, Pudel V, Roth C (2003) Obesity in patients with ­craniopharyngioma: assessment of food intake and movement counts indicating physical ­activity. J Clin Endocrinol Metab 88:5227–5231PubMedCrossRefGoogle Scholar
  74. 74.
    Finnegan L, Wilkie DJ, Wilbur J, Campbell RT, Zong S, Katula S (2007) Correlates of physical activity in young adult survivors of childhood cancers. Oncol Nurs Forum 34:E60–E69PubMedCrossRefGoogle Scholar
  75. 75.
    Bertorello N, Manicone R, Galletto C, Barisone E, Fagioli F (2011) Physical activity and late effects in childhood acute lymphoblastic leukemia long-term survivors. Pediatr Hematol Oncol 28:354–363PubMedCrossRefGoogle Scholar
  76. 76.
    Winter C, Muller C, Brandes M, Brinkmann A, Hoffmann C, Hardes J, Gosheger G, Boos J, Rosenbaum D (2009) Level of activity in children undergoing cancer treatment. Pediatr Blood Cancer 53:438–443PubMedCrossRefGoogle Scholar
  77. 77.
    Heath JA, Ramzy JM, Donath SM (2010) Physical activity in survivors of childhood acute lymphoblastic leukaemia. J Paediatr Child Health 46:149–153PubMedCrossRefGoogle Scholar
  78. 78.
    Arroyave WD, Clipp EC, Miller PE, Jones LW, Ward DS, Bonner MJ, Rosoff PM, Snyder DC, Demark-Wahnefried W (2008) Childhood cancer survivors’ perceived barriers to improving exercise and dietary behaviors. Oncol Nurs Forum 35:121–130PubMedCrossRefGoogle Scholar
  79. 79.
    Marchese VG, Chiarello LA, Lange BJ (2004) Effects of physical therapy intervention for children with acute lymphoblastic leukemia. Pediatr Blood Cancer 42:127–133PubMedCrossRefGoogle Scholar
  80. 80.
    Takken T, van der Torre P, Zwerink M, Hulzebos EH, Bierings M, Helders PJ, van der Net J (2009) Development, feasibility and efficacy of a community-based exercise training program in pediatric cancer survivors. Psychooncology 18:440–448PubMedCrossRefGoogle Scholar
  81. 81.
    Oldervoll LM, Kaasa S, Knobel H, Loge JH (2003) Exercise reduces fatigue in chronic fatigued hodgkins disease survivors – results from a pilot study. Eur J Cancer 39:57–63PubMedCrossRefGoogle Scholar
  82. 82.
    Moyer-Mileur LJ, Ransdell L, Bruggers CS (2009) Fitness of children with standard-risk acute lymphoblastic leukemia during maintenance therapy: response to a home-based exercise and nutrition program. J Pediatr Hematol Oncol 31:259–266PubMedCrossRefGoogle Scholar
  83. 83.
    Sharkey AM, Carey AB, Heise CT, Barber G (1993) Cardiac rehabilitation after cancer therapy in children and young adults. Am J Cardiol 71:1488–1490PubMedCrossRefGoogle Scholar
  84. 84.
    Shore S, Shepard RJ (1999) Immune responses to exercise in children treated for cancer. J Sports Med Phys Fitness 39:240–243PubMedGoogle Scholar
  85. 85.
    Hartman A, te Winkel ML, van Beek RD, de Muinck Keizer-Schrama SM, Kemper HC, Hop WC, van den Heuvel-Eibrink MM, Pieters R (2009) A randomized trial investigating an exercise program to prevent reduction of bone mineral density and impairment of motor performance during treatment for childhood acute lymphoblastic leukemia. Pediatr Blood Cancer 53:64–71PubMedCrossRefGoogle Scholar
  86. 86.
    Ladha AB, Courneya KS, Bell GJ, Field CJ, Grundy P (2006) Effects of acute exercise on neutrophils in pediatric acute lymphoblastic leukemia survivors: a pilot study. J Pediatr Hematol Oncol 28:671–677PubMedCrossRefGoogle Scholar
  87. 87.
    Chamorro-Vina C, Ruiz JR, Santana-Sosa E, Vicent MG, Madero L, Perez M, Fleck SJ, Perez A, Ramirez M, Lucia A (2009) Exercise during hematopoietic stem cell transplant hospitalization in children. Med Sci Sports ExercGoogle Scholar
  88. 88.
    Rosenhagen A, Bernhorster M, Vogt L, Weiss B, Senn A, Arndt S, Siegler K, Jung M, Bader P, Banzer W (2011) Implementation of structured physical activity in the pediatric stem cell transplantation. Klin Padiatr 223:147–151PubMedCrossRefGoogle Scholar
  89. 89.
    Chamorro-Vina C, Ruiz JR, Santana-Sosa E, Gonzalez Vicent M, Madero L, Perez M, Fleck SJ, Perez A, Ramirez M, Lucia A (2010) Exercise during hematopoietic stem cell transplant hospitalization in children. Med Sci Sports Exerc 42:1045–1053PubMedGoogle Scholar
  90. 90.
    Speyer E, Herbinet A, Vuillemin A, Briancon S, Chastagner P (2010) Effect of adapted physical activity sessions in the hospital on health-related quality of life for children with cancer: a cross-over randomized trial. Pediatr Blood Cancer 55:1160–1166PubMedCrossRefGoogle Scholar
  91. 91.
    Blaauwbroek R, Bouma MJ, Tuinier W, Groenier KH, de Greef MH, Meyboom-de Jong B, Kamps WA, Postma A (2008) The effect of exercise counselling with feedback from a pedometer on fatigue in adult survivors of childhood cancer: a pilot study. Support Care CancerGoogle Scholar
  92. 92.
    Hinds PS, Hockenberry M, Rai SN, Zhang L, Razzouk BI, Cremer L, McCarthy K, Rodriguez-Galindo C (2007) Clinical field testing of an enhanced-activity intervention in hospitalized children with cancer. J Pain Symptom Manage 33:686–697PubMedCrossRefGoogle Scholar
  93. 93.
    Wolin KY, Ruiz JR, Tuchman H, Lucia A (2010) Exercise in adult and pediatric hematological cancer survivors: an intervention review. Leukemia 24:1113–1120PubMedCrossRefGoogle Scholar
  94. 94.
    Norris JM, Moules NJ, Pelletier G, Culos-Reed SN (2010) Families of young pediatric cancer survivors: a cross-sectional survey examining physical activity behavior and health-related quality of life. J Pediatr Oncol Nurs 27:196–208PubMedCrossRefGoogle Scholar
  95. 95.
    Ruiz JR, Fleck SJ, Vingren JL, Ramirez M, Madero L, Fragala MS, Kraemer WJ, Lucia A (2010) Preliminary findings of a 4-month intrahospital exercise training intervention on igfs and igfbps in children with leukemia. J Strength Cond Res 24:1292–1297PubMedCrossRefGoogle Scholar
  96. 96.
    Hankinson SE, Willett WC, Colditz GA, Hunter DJ, Michaud DS, Deroo B, Rosner B, Speizer FE, Pollak M (1998) Circulating concentrations of insulin-like growth factor-i and risk of breast cancer. Lancet 351:1393–1396PubMedCrossRefGoogle Scholar
  97. 97.
    Chan JM, Stampfer MJ, Giovannucci E, Gann PH, Ma J, Wilkinson P, Hennekens CH, Pollak M (1998) Plasma insulin-like growth factor-i and prostate cancer risk: a prospective study. Science 279:563–566PubMedCrossRefGoogle Scholar
  98. 98.
    Tower RL, Spector LG (2007) The epidemiology of childhood leukemia with a focus on birth weight and diet. Crit Rev Clin Lab Sci 44:203–242PubMedCrossRefGoogle Scholar
  99. 99.
    Courneya KS (2009) Effects of aerobic exercise on physical functioning and quality of life in lymphoma patients: a randomized controlled trial. J ClinOncol 1–21Google Scholar
  100. 100.
    DeFor TE, Burns LJ, Gold EM, Weisdorf DJ (2007) A randomized trial of the effect of a walking regimen on the functional status of 100 adult allogeneic donor hematopoietic cell transplant patients. Biol Blood Marrow Transplant 13:948–955PubMedCrossRefGoogle Scholar
  101. 101.
    Coleman EA, Coon SK, Kennedy RL, Lockhart KD, Stewart CB, Anaissie EJ, Barlogie B (2008) Effects of exercise in combination with epoetin alfa during high-dose chemotherapy and autologous peripheral blood stem cell transplantation for multiple myeloma. Oncol Nurs Forum 35:E53–E61PubMedCrossRefGoogle Scholar
  102. 102.
    (2008) Physical activity guidelines advisory committee reportGoogle Scholar
  103. 103.
    Demark-Wahnefried W, Aziz NM, Rowland JH, Pinto BM (2005) Riding the crest of the teachable moment: promoting long-term health after the diagnosis of cancer. J Clin Oncol 23:5814–5830PubMedCrossRefGoogle Scholar
  104. 104.
    Lajous M, Mozaffarian D, Mozaffarian R, Schrag D, Adami HO (2011) Lifestyle prescriptions for cancer survivors and their communities. J Intern Med 269:88–93PubMedCrossRefGoogle Scholar
  105. 105.
    Chamorro-Vina C, Ruiz JR, Santana-Sosa E, Gonzalez Vicent M, Madero L, Perez M, Fleck SJ, Perez A, Ramirez M, Lucia A (2009) Exercise during hematopoietic stem cell transplant hospitalization in children. Med Sci Sports ExercGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Luisa Soares-Miranda
    • 1
  • Carmen Fiuza-Luces
    • 2
  • Alejandro Lucia
    • 2
  1. 1.Faculty of Sport, Research Center in Physical Activity, Health and LeisureUniversity of PortoPortoPortugal
  2. 2.Department of BiomedicineUniversidad Europea de MadridMadridSpain

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