ORIGINAL ARTICLES   

The Journal of Sports Medicine and Physical Fitness 1999 September;39(3):240-3

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

Immune responses to exercise in children treated for cancer

Shore S., Shepard R. J.

Graduate Programme in Exercise Sciences, University of Toronto, Defence and Civil Institute of Environmental Medicine, Toronto, Canada and Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada

Background. Children treat­ed for can­cer com­mon­ly ben­e­fit phys­io­log­i­cal­ly ­from mod­er­ate aero­bic train­ing, but it is ­less ­clear if impair­ment of the ­immune ­system sec­on­dary to chemo­ther­a­py reduc­es the immu­no­log­i­cal tol­er­ance of exer­cise rel­a­tive to nor­mal chil­dren.
Methods. Experimental ­design: a ­case ­series. Setting: hos­pi­tal labor­a­to­ry. Participants: six chil­dren ­aged 13-14 yr, suc­cess­ful­ly treat­ed for ­acute lym­pho­blas­tic leu­kae­mia and oth­er ­types of neo­plasms,­were com­pared ­with 11 nor­mal vol­un­teer chil­dren. Interventions: ­three of the sam­ple under­went 12 ­weeks train­ing at 70-85% of max­i­mal ­heart ­rate; the remain­ing ­three pro­vid­ed ­initial and ­final ­test ­data ­only. Measures: ­mood ­state (Piers-Harris ­test), anthro­po­met­ric ­data, max­i­mal oxy­gen ­intake, ­response to 30 min exer­cise chal­leng­es at anaer­o­bic thresh­old, and stan­dard ­immune meas­ures (dif­fe­ren­tial ­count, cyto­lyt­ic activ­ity, and mito­gen-­induced lym­pho­cyte pro­life­ra­tion) at ­rest, dur­ing and fol­low­ing sub­max­i­mal exer­cise.
Results. A low max­i­mal oxy­gen ­intake, ­excess of ­body fat, and ­high anx­ie­ty ­scores all ­improved ­with train­ing. Children who ­were ­still receiv­ing chem­o­ther­a­py ­showed low rest­ing CD3+, CD4+, CD8+, CD19+ and CD25+ ­counts and ­reduced PHA-­induced pro­life­ra­tion. Acute exer­cise and train­ing ­caused fur­ther impair­ment of ­immune respons­es, ­although chang­es ­remained insuf­fi­cient to ­cause con­cern for ­health.
Conclusions. Exercise ther­a­py is ben­e­fi­cial fol­low­ing treat­ment of can­cer, but ­should be pre­scribed indi­vid­u­al­ly, ­with a care­ful mon­i­tor­ing of ­immune respons­es.