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4. Machine learning strategies to predict late adverse effects in childhood acute lymphoblastic leukemia survivors

Author

Raymond, Nicolas, Caru, Maxime, Laribi, Hakima, Mitiche, Mehdi, Marcil, Valérie, Krajinovic, Maja, Curnier, Daniel, Sinnett, Daniel, and Vallières, Martin

Subjects
Quantitative Biology - Quantitative Methods
Abstract

Acute lymphoblastic leukemia is the most frequent pediatric cancer. Approximately two third of survivors develop one or more health complications known as late adverse effects following their treatments. The existing measures offered to patients during their follow-up visits to the hospital are rather standardized for all childhood cancer survivors and not necessarily personalized for childhood ALL survivors. As a result, late adverse effects may be underdiagnosed and, in most cases, only taken care of following their appearance. Thus, it is necessary to predict these treatment-related conditions earlier in order to prevent them and enhance the survivors' health. Multiple studies have investigated the development of late adverse effects prediction tools to offer better personalized follow-up methods. However, no solution integrated the usage of neural networks to date. In this work, we developed graph-based parameters-efficient neural networks and promoted their interpretability with multiple post-hoc analyses. We first proposed a new disease-specific VO$_2$ peak prediction model that does not require patients to participate to a physical function test (e.g., 6-minute walk test) and further created an obesity prediction model using clinical variables that are available from the end of childhood ALL treatment as well as genomic variables. Our solutions were able to achieve better performance than linear and tree-based models on small cohorts of patients ($\leq$ 223) for both tasks., Comment: Submitted to Communications Medicine

Published
2022

12. Echocardiographic Parameters Associated With Cardiorespiratory Fitness and Physical Activity in Childhood Acute Lymphoblastic Leukemia Survivors.

Author

Caru, Maxime, Dubois, Pierre, Curnier, Daniel, Andelfinger, Gregor, Krajinovic, Maja, Laverdière, Caroline, Sinnett, Daniel, and Périé, Delphine

Subjects
CARDIOPULMONARY fitness, PHYSICAL fitness, PHYSICAL activity, LYMPHOBLASTIC leukemia, ACUTE leukemia
Abstract

Background: Children's exposure to chemotherapeutic agents causes several long-term adverse effects but physical activity has been evidenced to be an effective strategy to improve cardiac function. This cross-sectional study aimed to explore the association between physical activity levels, cardiorespiratory fitness, and cardiac parameters measured by echocardiography. Methods: Participants were 216n childhood acute lymphoblastic leukemia survivors who underwent a maximal cardiopulmonary exercise test and self-reported their daily minutes of moderate to vigorous physical activity. They underwent a complete transthoracic echocardiographic assessment. Systolic and diastolic function analysis and strain images analysis were performed. The associations were studied through the preventive fraction (examined with univariate crude and adjusted logistic regression models) of regular physical activity (≥150 min·wk−1) and adequate cardiorespiratory fitness levels (above the median ≥ 32.0 mL·kg−1·min−1) on cardiac parameters. Results: Crude analysis shows that regular physical activity was associated with a significant preventive fraction in mitral E/A ratio (56%; P =.013), while adjusted analyses highlighted a nonsignificant reduction of 74% to 37% in the prevalence of cardiac parameters associated with physical activity. Similar associations of adequate cardiorespiratory fitness on cardiac parameters were observed. Adjusted analyses revealed a nonsignificant reduction of 7% to 86% in the prevalence of cardiac parameters associated with cardiorespiratory fitness. Conclusion: This study reports that regular physical activity and adequate cardiorespiratory fitness were associated with a higher preventive fraction. Thus, engaging in physical activity prevents childhood acute lymphoblastic leukemia survivors' cardiac dysfunctions. These findings are novel and clinically relevant in pediatric cardiooncology and provide additional evidence to strengthen the benefits of exercise as long-term care in childhood cancer survivors. [ABSTRACT FROM AUTHOR]

Published
2023
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16. The Effects of Cycle Ergometer Versus Treadmill Exercise Stress Testing on QTc Interval Prolongation in Patients With Long QT Syndrome: A Systematic Review and Meta-analysis.

Author

Harvey, Audrey, Curnier, Daniel, Dodin, Philippe, Jacquemet, Vincent, and Caru, Maxime

Subjects
*LONG QT syndrome treatment, *MEDICAL information storage & retrieval systems, *SPORTS medicine, *ERGOMETRY, *TREATMENT effectiveness, *META-analysis, *DESCRIPTIVE statistics, *CARDIOPULMONARY system, *HEART beat, *SYSTEMATIC reviews, *MEDLINE, *CYCLING, *TREADMILLS, *EXERCISE tests, *ONLINE information services, *CONFIDENCE intervals, *QUALITY assurance
Abstract

Objective: The safest and most effective exercise stress tests (EST) modalities for long QT syndrome (LQTS) are currently unknown. The main objective was to explore the effects of EST on the corrected QT interval (QTc) in patients with LQTS, and to compare the effects of different EST modalities (cycle ergometer vs treadmill). Data Sources: Systematic searches were performed in September 2022 in accordance with the PRISMA statement through PubMed, Medline, EBM Reviews, Embase, and Web of Science. Main Results: A total of 1728 patients with LQTS, whether congenital or acquired, without any age restrictions (pediatric age#18 years and adult age.19 years), and 2437 control subjects were included in the 49 studies. The QT interval data were available for 15 studies. Our analyses showed that the QT interval prolonged in a similar manner using either a cycle ergometer or a treadmill (standardized mean difference [SMD] 5 1.89 [95% CI, 1.07-2.71] vs SMD 5 1.46 [95% CI, 0.78-2.14], respectively). Therefore, it seems that either modality may be used to evaluate patients with LQTS. Conclusions: The methodology for the measurement of the QT interval was very heterogeneous between studies, which inevitably influenced the quality of the analyses. Hence, researchers should proceed with caution when exploring and interpreting data in the field of exercise and LQTS. [ABSTRACT FROM AUTHOR]

Published
2024
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17. Predictors of low and very low bone mineral density in long‐term childhood acute lymphoblastic leukemia survivors: Toward personalized risk prediction

Author

Nadeau, Geneviève, primary, Samoilenko, Mariia, additional, Fiscaletti, Melissa, additional, Veilleux, Louis‐Nicolas, additional, Curnier, Daniel, additional, Laverdière, Caroline, additional, Sinnett, Daniel, additional, Krajinovic, Maja, additional, Lefebvre, Geneviève, additional, and Alos, Nathalie, additional

Published
2024
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19. Cardiorespiratory Fitness and Cardiac Magnetic Resonance Imaging in Childhood Acute Lymphoblastic Leukemia Survivors.

Author

Caru, Maxime, Curnier, Daniel, Dubois, Pierre, Friedrich, Matthias G., Andelfinger, Gregor, Krajinovic, Maja, Laverdière, Caroline, Sinnett, Daniel, and Périé, Delphine

Subjects
CARDIAC magnetic resonance imaging, CARDIOPULMONARY fitness, LYMPHOBLASTIC leukemia, ACUTE leukemia, EXERCISE tests
Abstract

Background: Childhood acute lymphoblastic leukemia survivors' anthracycline-induced cardiotoxicity could be prevented with good cardiorespiratory fitness levels and regular physical activity. This cross-sectional study aimed to assess the association between cardiorespiratory fitness and physical activity with cardiac magnetic resonance parameters. Methods: A total of 96 childhood acute lymphoblastic leukemia survivors underwent a maximal cardiopulmonary exercise test and answered physical activity questionnaires. We calculated the odds ratio of the preventive fraction of regular physical activity (≥150 min/wk) and adequate cardiorespiratory fitness levels (above the median ≥31.4 mL·kg−1·min−1) on cardiac magnetic resonance parameters (left ventricular [LV] and right ventricular [RV] morphological and functional parameters). Results: An adequate cardiorespiratory fitness was associated with a significant preventive fraction for LV (up to 84% for LV end-diastolic volume) and RV volumes (up to 88% for RV end-systolic volume). The adjusted analyses highlighted a preventive fraction of 36% to 91% between an adequate cardiorespiratory fitness and LV and RV parameters, late gadolinium enhancement fibrosis, and cardiac magnetic resonance relaxation times. No associations were reported with regular physical activity. Conclusions: This study provides additional evidence regarding the benefits of an adequate cardiorespiratory fitness level for childhood cancer survivors' cardiac health. [ABSTRACT FROM AUTHOR]

Published
2023
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31. Increased Incidence but Lack of Association Between Cardiovascular Risk Factors in Adults Born Preterm

Author

Flahault, Adrien, Paquette, Katryn, Fernandes, Rafael Oliveira, Delfrate, Jacques, Cloutier, Anik, Henderson, Mélanie, Lavoie, Jean-Claude, Mâsse, Benoît, Nuyt, Anne Monique, Luu, Thuy Mai, Alos, Nathalie, Bertagnolli, Mariane, Bigras, Jean-Luc, Curnier, Daniel, Dartora, Daniela Ravizzoni, Ducruet, Thierry, El-Jalbout, Ramy, Girard-Bock, Camille, Gyger, Geneviève, Hamel, Patrick, Lapeyraque, Anne-Laure, Mian, Muhammad Oneeb Rehman, Orlando, Valérie, and Xie, Li Feng

Published
2020
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37. Physical impairments, activity limitations, and participation restrictions of childhood acute lymphoblastic leukemia survivors: A PETALE cohort study

Author

Brochu, Annie, primary, Kairy, Dahlia, additional, Alos, Nathalie, additional, Laverdière, Caroline, additional, Sinnett, Daniel, additional, Sultan, Serge, additional, Curnier, Daniel, additional, Miron, Marie-Claude, additional, El-Jalbout, Ramy, additional, Fiscaletti, Melissa, additional, and Hébert, Luc J., additional

Published
2023
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42. Prevention of Long-term Adverse Health Outcomes With Cardiorespiratory Fitness and Physical Activity in Childhood Acute Lymphoblastic Leukemia Survivors

Author

Lemay, Valérie, Caru, Maxime, Samoilenko, Mariia, Drouin, Simon, Alos, Nathalie, Lefebvre, Geneviève, Levy, Emile, Lippé, Sarah, Marcil, Valérie, Sultan, Serge, Bertout, Laurence, Krajinovic, Maja, Laverdière, Caroline, Raboisson, Marie-Josée, Sinnett, Daniel, Andelfinger, Gregor, and Curnier, Daniel

Published
2019
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44. Preventive Action Of Cardiorespiratory Fitness On Health Outcomes In Childhood Acute Lymphoblastic Leukemia Survivors: 1553 Board #315 May 30 10:30 AM - 12:00 PM

Author

Caru, Maxime, Lemay, Valérie, Samoilenko, Mariia, Drouin, Simon, Alos, Nathalie, Lefebvre, Geneviève, Levy, Emile, Lippé, Sarah, Marcil, Valérie, Sultan, Serge, Bertout, Laurence, Krajinovic, Maja, Laverdiere, Caroline, Raboisson, Marie-Josée, Andelfinger, Gregor, Sinnett, Daniel, and Curnier, Daniel

Published
2019
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45. Trainability Genes Provide Answers To The Cardiorespiratory Fitness Deficit In Childhood Acute Lymphoblastic Leukemia Survivors.: 600 May 29 1:40 PM - 1:50 PM

Author

Caru, Maxime, Petrykey, Kateryna, Samoilenko, Mariia, Drouin, Simon, Lemay, Valérie, Kern, Laurence, Romo, Lucia, Beaulieu, Patrick, St-Onge, Pascal, Bertout, Laurence, Lefebvre, Geneviève, Leverdiere, Caroline, Andelfinger, Gregor, Krajinovic, Maja, Sinnett, Daniel, and Curnier, Daniel

Published
2019
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47. Substrate oxidation during exercise in childhood acute lymphoblastic leukemia survivors.

Author

Bertrand, Émilie, Caru, Maxime, Morel, Sophia, Bergeron Parenteau, Alice, Belanger, Veronique, Laverdière, Caroline, Krajinovic, Maja, Sinnett, Daniel, Levy, Emile, Marcil, Valérie, and Curnier, Daniel

Subjects
LYMPHOBLASTIC leukemia, ACUTE leukemia, EXERCISE tests, OXIDATION, EXERCISE intensity
Abstract

Children with acute lymphoblastic leukemia (ALL) are at high risk of developing long-term cardiometabolic complications during their survivorship. Maximal fat oxidation (MFO) is a marker during exercise of cardiometabolic health, and is associated with metabolic risk factors. Our aim was to characterize the carbohydrate and fat oxidation during exercise in childhood ALL survivors. Indirect calorimetry was measured in 250 childhood ALL survivors to quantify substrate oxidation rates during a cardiopulmonary exercise test. A best-fit third-order polynomial curve was computed for fat oxidation rate (mg/min) against exercise intensity (% V ̇ O2peak) and was used to determine the MFO and the peak fat oxidation (Fatmax). The crossover point was also identified. Differences between prognostic risk groups were assessed (ie, standard risk [SR], high risk with and without cardio-protective agent dexrazoxane [HR + DEX and HR]). MFO, Fatmax and crossover point were not different between the groups (p =.078; p =.765; p =.726). Fatmax and crossover point were achieved at low exercise intensities. A higher MFO was achieved by men in the SR group (287.8 ± 111.2 mg/min) compared to those in HR + DEX (239.8 ± 97.0 mg/min) and HR groups (229.3 ± 98.9 mg/min) (p =.04). Childhood ALL survivors have low fat oxidation during exercise and oxidize carbohydrates at low exercise intensities, independently of the cumulative doses of doxorubicin they received. These findings alert clinicians on the long-term impact of cancer treatments on childhood ALL survivors' substrate oxidation. [ABSTRACT FROM AUTHOR]

Published
2023
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50. Additional file 1 of Abnormal HDL lipid and protein composition following pediatric cancer treatment: an associative study

Author

Bélanger, Véronique, Morel, Sophia, Napartuk, Mélanie, Bouchard, Isabelle, Meloche, Caroline, Curnier, Daniel, Sultan, Serge, Laverdière, Caroline, Sinnett, Daniel, and Marcil, Valérie

Abstract

Additional file 1: Supplementary Table 1. Clinical characteristics of post-treatment pediatric cancer patients: comparison based on age group at diagnosis.

Published
2023
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