Evidence map›Paper›PMID 35403603›Full record

ArticleJMIR research protocols2022

Dexamethasone-Induced Sarcopenia and Physical Frailty in Children With Acute Lymphoblastic Leukemia: Protocol for a Prospective Cohort Study.

Emma Jacobine Verwaaijen, Annelienke van Hulst, Marta Fiocco, Annelies Hartman, Martha Grootenhuis, Saskia Pluijm, Rob Pieters, Erica van den Akker, Marry M van den Heuvel-Eibrink

Open access · goldAbstract read
In one paragraph

Article in JMIR research protocols, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
3.8field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 10 citations in OpenAlex.

  1. Review
  2. The evolution of nutritional care in children and young people with acute lymphoblastic leukaemia: a narrative review.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2025
    Review
  3. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Emma Jacobine VerwaaijenPrincess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.ORCID https://orcid.org/0000-0003-1350-3363
Annelienke van HulstPrincess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.ORCID https://orcid.org/0000-0002-1006-3481
Marta FioccoPrincess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.ORCID https://orcid.org/0000-0001-5588-0277
Annelies HartmanDepartment of Pediatric Physiotherapy, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands.ORCID https://orcid.org/0000-0002-6892-4854
Martha GrootenhuisPrincess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.ORCID https://orcid.org/0000-0002-9632-248X
Saskia PluijmPrincess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.ORCID https://orcid.org/0000-0001-7695-030X
Rob PietersPrincess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.ORCID https://orcid.org/0000-0003-2997-3570
Erica van den AkkerDepartment of Endocrinology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands.ORCID https://orcid.org/0000-0001-5352-9328
Marry M van den Heuvel-EibrinkPrincess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.ORCID https://orcid.org/0000-0002-7760-879X
Princess Máxima Center · NLErasmus MC - Sophia Children’s Hospital · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDuring treatment for pediatric acute lymphoblastic leukemia (ALL), children receive high doses of dexamethasone for its apoptotic effect on leukemia cells; however, muscle atrophy is a well-known serious side effect. Muscle atrophy (loss of muscle mass) accompanied by a decreased muscle strength may lead to a generalized impaired skeletal muscle state called sarcopenia. Loss of muscle mass is also an indicator of physical frailty, which is defined as a state of increased vulnerability that is characterized by co-occurrence of low muscle mass, muscle weakness, fatigue, slow walking speed, and low physical activity. Both sarcopenia and physical frailty are related to an increased risk of infections, hospitalizations, and decreased survival in children with chronic diseases.

objectiveThis study aims to (1) estimate the occurrence of sarcopenia and physical frailty in children during ALL maintenance therapy, (2) evaluate the effect of administering dexamethasone, and (3) explore determinants associated with these outcomes.

methodsThis prospective study is being pursued within the framework of the DexaDays-2 study: a randomized controlled trial on neurobehavioral side effects in pediatric patients with ALL. A total of 105 children (3-18 years) undergoing ALL maintenance treatment at the Princess Máxima Center for Pediatric Oncology are included in this study. Sarcopenia/frailty assessments are performed before and just after a 5-day dexamethasone course. A subset of 50 children participating in the DexaDays-2 trial because of severe dexamethasone-induced neurobehavioral problems were assessed at 3 additional timepoints. The sarcopenia/frailty assessment consists of bioimpedance analysis (skeletal muscle mass [SMM]), handheld dynamometry (handgrip strength), Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (fatigue), Timed Up and Go Test (TUG; walking speed), and physical activity questionnaires. To evaluate potential change in sarcopenia/frailty components after a 5-day dexamethasone administration, a paired Student t test or Mann-Whitney U test will be used. Because of the presence of repeated measurements, generalized linear mixed models will be used to estimate the effect of dexamethasone on sarcopenia and frailty outcomes. Multivariable regression models will be estimated to investigate associations between the assessment scores and patient and treatment-related factors.

resultsPatient accrual started in 2018 and was finalized in spring 2021. From autumn 2021 onward final data analyses will be performed.

conclusionsThis first study combining parameters of sarcopenia and physical frailty is of importance because these conditions can seriously complicate continuation of ALL therapy, independence in physical functioning, reaching motor milestones, and participating in daily life activities. The results will provide knowledge about these complications, the association between dexamethasone treatment and muscle loss and other components of frailty, and therefore insights into the severity of this side effect. By exploring potential determinants that may be associated with sarcopenia and physical frailty, we may be able to identify children at risk at an earlier stage and provide timely interventions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/33517.

Indexed as

acute lymphoblastic leukemiadexamethasonefatigueglucocorticoid-induced atrophymuscle atrophyphysical activityphysical frailtysarcopenia

Identifiers

PMID35403603
PMCPMC9039819
OpenAlexW4210850973

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.