ArticlePediatric blood & cancer2014
Impairment in circadian activity rhythms occurs during dexamethasone therapy in children with leukemia.
Article in Pediatric blood & cancer, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Prevalence and Factors Associated With Cancer-Related Fatigue Among Children and Adolescents Undergoing Cancer Treatment: A Systematic Review and Meta-Analysis.Cancer medicine · 2024Pooled it
- Risk factors for steroid-induced adverse psychological reactions and sleep problems in pediatric acute lymphoblastic leukemia: A systematic review.Psycho-oncology · 2021Pooled it
- Relationship between circadian activity rhythms and fatigue in hospitalized children with CNS cancers receiving high-dose chemotherapy.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2020Trial
- Circadian rhythm-guided cellular therapy in hematologic malignancies: mechanisms, clinical evidence, and optimization strategies.Biomarker research · 2026Review
- Scoping review of the utilization of wearable devices in pediatric and young adult oncology.NPJ digital medicine · 2025Article
- Evaluating Sleep in Pediatric Cancer: A Scoping Review of Assessment Tools for Quality and Care.Cancer medicine · 2025Article
- Review: therapeutic approaches for circadian modulation of the glioma microenvironment.Frontiers in oncology · 2023Review
- Association between fatigue and sleep disturbances during treatment for pediatric acute lymphoblastic leukemia and posttreatment neurocognitive performance.Pediatric blood & cancer · 2022Article
- Article
- Circadian disruption and cancer- and treatment-related symptoms.Frontiers in oncology · 2022Review
- Prevalence of Sleep Disturbances in Pediatric Cancer Patients and Their Diagnosis and Management.Children (Basel, Switzerland) · 2021Review
- Article
- The impact of maintenance therapy on sleep-wake rhythms and cancer-related fatigue in pediatric acute lymphoblastic leukemia.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2020Article
- Circadian activity rhythms and fatigue of adolescent cancer survivors and healthy controls: a pilot study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2020Article
- Article
- A call to action for expanded sleep research in pediatric oncology: A position paper on behalf of the International Psycho-Oncology Society Pediatrics Special Interest Group.Psycho-oncology · 2020Review
- Initial Validation of the Sleep Disturbances in Pediatric Cancer Model.Journal of pediatric psychology · 2016Article
- Gaps in Parental Understanding of Sleep Disturbances During Maintenance Therapy for Pediatric Acute Lymphoblastic Leukemia.Journal of pediatric hematology/oncology nursingArticle
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundCircadian rhythm disturbances in adults with cancer are associated with fatigue, time to relapse, and death. This study of circadian activity rhythms (CAR) of children with acute lymphoblastic leukemia (ALL) on continuation chemotherapy aimed to describe CAR before and after starting dexamethasone, and to determine whether fatigue was associated with less robust CAR. PROCEDURE: This was a secondary analysis of data from a multi-institutional study in which children with ALL aged 5-18 years wore an actigraph for 10 consecutive 24-hour periods, five before and five during dexamethasone therapy. CAR parameters measured by actigraphy were calculated for each 5-day period, including peak activity, MESOR, amplitude, acrophase, and circadian quotient. Fatigue was measured on study days 2, 5, 7, and 10 by parent-report and self-report for children ≥ 7 years.
resultsEighty-two children qualified for CAR analysis, and 87 for analysis of daily peak activity patterns and fatigue. Mean age was 8.8 ± 3.3 years. Peak activity, MESOR, and amplitude significantly decreased during dexamethasone therapy. Children on high-dose dexamethasone (8 or 12 mg/m(2)/d) had significantly higher (better, or more robust) values of several CAR parameters than those on low-dose (6 mg/m(2)/d). There was a significant trend of decreasing daily pattern of peak activity during dexamethasone therapy only. Fatigue increased across the study and was associated with decreasing CAR peak activity, MESOR, and amplitude.
conclusionsDexamethasone initiation was associated with a decrease in several CAR parameters, and a significant decrease in the trend of daily peak activity. Fatigue was associated with less robust CAR.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.