Frailty in Children and Adolescents With Acute Lymphoblastic Leukemia or Lymphoblastic Lymphoma Receiving Maintenance...

Frailty is a measure of global infirmity and impaired physical function that has been correlated with adverse health outcomes and an elevated incidence of mortality in adult childhood cancer survivors. The aim of this study is to assess the frailty phenotype in youth receiving maintenance chemotherapy for acute lymphoblastic leukemia or lymphoblastic lymphoma. Children and adolescents diagnosed with acute lymphoblastic leukemia or lymphoblastic lymphoma in the first cycle of their maintenance chemotherapy were prospectively recruited. Frailty was assessed at an initial visit in cycle 1 of maintenance treatment (V1) and 6 months following (V2). Frailty points were assigned for each domain, which generated a composite score ranging from 0 (least frail) to 25 (most frail). Paired analysis of the V2 frailty assessment demonstrated significant improvement in exhaustion/fatigue ( P <0.001) and composite frailty score ( P =0.003). Children receiving maintenance chemotherapy scored poorly in all 5 domains of frailty, with improvement in some subdomains and composite scores. Improvement in exhaustion and composite frailty score was noted at V2 without any targeted interventions. Given that frailty has been shown to persist into adulthood in survivors of childhood cancer, frailty assessment may be an effective tool for identifying patients who may require additional intervention before adulthood.