{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T21:12:53Z","timestamp":1769634773103,"version":"3.49.0"},"reference-count":66,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Childhood acute lymphoblastic leukemia (ALL) survivors face an increased risk of pulmonary function deficit (PFD), which may affect physical functioning. We aimed to evaluate parent proxy\u2010 and self\u2010reported physical functioning and the association with PFD and abnormal bronchodilator response (\u2009+\u2009BDR) among survivors versus controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This cross\u2010sectional study (February 2019\u2013May 2024) included\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009184 ALL survivors (aged 5\u201317.9 years) from a national NOPHO ALL2008 protocol\u2010treated cohort (eligible,\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009295) (\u2009\u2265\u20091 year after treatment cessation) and 207 controls. Physical functioning was assessed using the Paediatric Quality of Life Inventory (PedsQL) questionnaire. Pulmonary function tests (PFTs) identified PFD (abnormal PFT) and +BDR according to ERS\/ATS criteria. Ordinal logistic regression and t\u2010test compared groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      ALL survivor parents proxy\u2010reported significantly poorer physical functioning than controls (mean difference [MD] \u221213.3 95% CI [\u221216.3; \u221210.3] to MD \u221210.3 [\u221217.2; \u22123.3],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 to\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), but clinically significant impairments were restricted to parent proxy\u2010reports from survivors treated with high\u2010risk (HR) chemotherapy (MD \u221219.9 [\u221229.0; \u221210.7] to \u221211.5 [\u221217.5; \u22125.6],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and stem cell transplantation (HR\u2010SCT) (MD \u221224.7 [\u221230.1; \u221219.4] to \u221216.9 [\u221227.4; \u22126.5],\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001 to\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) as well as self\u2010reports from HR (MD \u221211.2 [\u221218.9; \u22123.4],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006) and HR\u2010SCT survivors (MD \u221214.5 [\u221224.1; \u22124.8],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). Among 5\u201315\u2010year\u2010olds, PFD\/\u2009+\u2009BDR was associated with significantly poorer parent proxy\u2010reported physical functioning in survivors versus controls (MD \u221214.3 [\u221221.2; \u22127.3],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Significant deficits in these groups related to running, engaging in sports\/exercise and lifting heavy objects. PFD\/\u2009+\u2009BDR was not associated with poorer physical functioning reports within survivors (MD \u22122.5 [\u22129.0; 3.3] to 0.1 [\u221213.7; 13.8],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.36\u20130.99).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Physical functioning in survivors compared to controls varies with intensity of treatment, most evident in HR and HR\u2010SCT survivors, with impairments linked to PFD and +BDR in the youngest. Among survivors, physical functioning did not align with PFD and +BDR status, highlighting the need for parallel assessment of objective and subjective measures during follow\u2010up. Baseline PFT and tailored follow\u2010up are essential for high\u2010risk groups, to detect PFD early and intervene.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71389","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T06:49:06Z","timestamp":1763534946000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Physical Functioning Report and Pulmonary Function Deficit in Childhood and Adolescent Acute Lymphoblastic Leukemia Survivors: A National Cross\u2010Sectional ALL\u2010STAR Lungs Study"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0144-2196","authenticated-orcid":false,"given":"Sonja Izquierdo Riis","family":"Meyer","sequence":"first","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine, Danish Centre of Paediatric Pulmonology and Allergology Aarhus University Hospital Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6281-4814","authenticated-orcid":false,"given":"Mette Tiedemann","family":"Skipper","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"},{"name":"Department of Paediatrics and Adolescent Medicine, Centre for Paediatric and Adolescent Cancer Aarhus University Hospital Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3902-3694","authenticated-orcid":false,"given":"Birgitte Klug","family":"Albertsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"},{"name":"Department of Paediatrics and Adolescent Medicine, Centre for Paediatric and Adolescent Cancer Aarhus University Hospital Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2024-0553","authenticated-orcid":false,"given":"Ruta","family":"Tuckuviene","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Aalborg University Hospital Aalborg Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peder Skov","family":"Wehner","sequence":"additional","affiliation":[{"name":"Department of Paediatric Haematology and Oncology, H.C. 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