{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T03:38:57Z","timestamp":1782963537454,"version":"3.54.5"},"reference-count":64,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T00:00:00Z","timestamp":1639612800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Children: adolescents, and young who are adults affected with hematological malignancies (CAYA-H) and who are undergoing intensive phases of cancer treatment, including hematopoietic stem cell transplantation (HSCT), experience diminished functional ability. This study was aimed at assessing the feasibility, efficacy, safety, and satisfaction of an osteopathic intervention in CAYA-H attending an 11-week precision-based exercise program (PEx). All of the participants were given 4\u201310 treatments according to the prescription ordered by the sports medicine doctor in charge of the PEx, and the following outcomes were assessed: (1) spinal column range of motion (ROM) by palpation; (2) lower and upper limb joints ROM by a goniometer; (3) orthostatic posture by plumb line assessment; (4) chest and abdomen mobility by inspection and palpation; (5) cranial-sacral rhythmic impulse (CRI) by palpation; and (6) adverse effects. Goal attainment scaling (GAS) was used to identify the accomplishment of a desired clinical result. Moreover, HSCT patients who were affected with graft-versus-host disease and\/or osteonecrosis had their joints assessed in terms of ROM as tools to monitor the effectiveness of immunosuppressive treatment. A total of 231 CAYA-H were identified, and 104 participated in the study (age 10.66 \u00b1 4.51 yrs; 43% F). PEx plus osteopathy reached positive GAS scores by improving the ROMs of the spinal column and\/or limbs (81% and 78%, respectively), chest and abdomen mobility (82%), and CRI (76%). Only minor reversible adverse effects were noticed during the study. Together, our data seem to initiate a new course where osteopathy could be useful in evaluating structural edges due to the clinical history of each CAYA-H. Given the contributions that were obtained by the GAS scores, osteopathic treatment seems to reveal interesting potential that can be targeted in the future.<\/jats:p>","DOI":"10.3390\/cancers13246321","type":"journal-article","created":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T11:27:36Z","timestamp":1639654056000},"page":"6321","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Osteopathic Treatment and Evaluation in the Clinical Setting of Childhood Hematological Malignancies"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3173-5400","authenticated-orcid":false,"given":"Monica","family":"Barbieri","sequence":"first","affiliation":[{"name":"Maria Letizia Verga Center, Department of Pediatrics, University of Milano-Bicocca, ASST Monza\/MBBM Foundation, 20900 Monza, Italy"},{"name":"Division of Research, Italian Academy of Osteopathic Medicine (AIMO), 21047 Saronno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Zardo","sequence":"additional","affiliation":[{"name":"Maria Letizia Verga Center, Department of Pediatrics, University of Milano-Bicocca, ASST Monza\/MBBM Foundation, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Frittoli","sequence":"additional","affiliation":[{"name":"Maria Letizia Verga Center, Department of Pediatrics, University of Milano-Bicocca, ASST Monza\/MBBM Foundation, 20900 Monza, Italy"},{"name":"Division of Research, Italian Academy of Osteopathic Medicine (AIMO), 21047 Saronno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2617-9294","authenticated-orcid":false,"given":"Clara","family":"Rivolta","sequence":"additional","affiliation":[{"name":"Maria Letizia Verga Center, Department of Pediatrics, University of Milano-Bicocca, ASST Monza\/MBBM Foundation, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6537-9371","authenticated-orcid":false,"given":"Valeria","family":"Valdata","sequence":"additional","affiliation":[{"name":"Maria Letizia Verga Center, Department of Pediatrics, University of Milano-Bicocca, ASST Monza\/MBBM Foundation, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2274-7629","authenticated-orcid":false,"given":"Federico","family":"Bouquin","sequence":"additional","affiliation":[{"name":"Maria Letizia Verga Center, Department of Pediatrics, University of Milano-Bicocca, ASST Monza\/MBBM Foundation, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1424-0094","authenticated-orcid":false,"given":"Greta","family":"Passignani","sequence":"additional","affiliation":[{"name":"Maria Letizia Verga Center, Department of Pediatrics, University of Milano-Bicocca, ASST Monza\/MBBM Foundation, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Maggiani","sequence":"additional","affiliation":[{"name":"Division of Research, Italian Academy of Osteopathic Medicine (AIMO), 21047 Saronno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Momcilo","family":"Jankovic","sequence":"additional","affiliation":[{"name":"Maria Letizia Verga Center, Department of Pediatrics, University of Milano-Bicocca, ASST Monza\/MBBM Foundation, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0781-431X","authenticated-orcid":false,"given":"Andrea","family":"Cossio","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, University of Milano-Bicocca, ASST Monza, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Biondi","sequence":"additional","affiliation":[{"name":"Maria Letizia Verga Center, Department of Pediatrics, University of Milano-Bicocca, ASST Monza\/MBBM Foundation, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5879-0610","authenticated-orcid":false,"given":"Adriana","family":"Balduzzi","sequence":"additional","affiliation":[{"name":"Maria Letizia Verga Center, Department of Pediatrics, University of Milano-Bicocca, ASST Monza\/MBBM Foundation, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5777-0821","authenticated-orcid":false,"given":"Francesca","family":"Lanfranconi","sequence":"additional","affiliation":[{"name":"Maria Letizia Verga Center, Department of Pediatrics, University of Milano-Bicocca, ASST Monza\/MBBM Foundation, 20900 Monza, 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Italian cancer figures, report 2012: Cancer in children and adolescents. Epidemiol. Prev., 37, 1\u2013225."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.jcpo.2016.03.007","article-title":"The SIOPE strategic plan: A European cancer plan for children and adolescents","volume":"8","author":"Vassal","year":"2016","journal-title":"J. Cancer Policy"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1097\/MPH.0000000000000067","article-title":"Muscle strength, motor performance, cardiac and muscle biomarkers in detection of muscle side effects during and after acute lymphoblastic leukemia treatment in children","volume":"36","author":"Akyay","year":"2014","journal-title":"J Pediatr. Hematol.\/Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1038\/bjc.1998.436","article-title":"Pulmonary function after treatment for acute lymphoblastic leukaemia in childhood","volume":"78","author":"Nysom","year":"1998","journal-title":"Br. J. Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Lanfranconi, F., Pollastri, L., Ferri, A., Fraschini, D., Masera, G., and Miserocchi, G. (2014). Near infrared spectroscopy (NIRS) as a new non-invasive tool to detect oxidative skeletal muscle impairment in children survived to acute lymphoblastic leukaemia. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0099282"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"341","DOI":"10.2522\/ptj.20070108","article-title":"Relationships among severity of osteonecrosis, pain, range of motion, and functional mobility in children, adolescent, and young adults with acute lymphoblastic leukemia","volume":"88","author":"Marchese","year":"2008","journal-title":"Phys. Ther."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1002\/mpo.1084","article-title":"Motor nervous pathway function is impaired after treatment of childhood acute lymphoblastic leukemia: A study with motor evoked potentials","volume":"36","author":"Huuskonen","year":"2001","journal-title":"Med. Pediatr. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1002\/cncr.24043","article-title":"Promoting physical activity in childhood cancer survivors","volume":"115","author":"Cox","year":"2009","journal-title":"Cancer"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s00520-018-4483-8","article-title":"Short and long-term impairments of cardiopulmonary fitness level in previous childhood cancer cases: A systematic review","volume":"27","author":"YildizKabak","year":"2019","journal-title":"Support. Care Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.3109\/10428194.2014.944519","article-title":"Skeletal, neuromuscular and fitness impairments among children with newly diagnosed acute lymphoblastic leukemia","volume":"56","author":"Ness","year":"2015","journal-title":"Leuk. Lymphoma"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1080\/08880018.2016.1219796","article-title":"Muscle strength and QoL in patients with childhood cancer at early phase of primary treatment","volume":"33","author":"Deisenroth","year":"2016","journal-title":"Pediatr. Hematol. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1002\/pbc.21325","article-title":"Decrease in Peripheral Muscle Strength and Ankle Dorsiflexion as Long-Term Side Effects of Treatment for Childhood Cancer","volume":"50","author":"Hartman","year":"2008","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1249\/01.mss.0000240326.54147.fc","article-title":"Effects of an intrahospital exercise program intervention for children with leukemia","volume":"39","author":"Fleck","year":"2007","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_14","first-page":"387","article-title":"Effects of a combined aerobic and strength training program in youth patients with acute lymphoblastic leukemia","volume":"1","author":"Perondi","year":"2012","journal-title":"J. Sports Sci. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1249\/MSS.0000000000001094","article-title":"Exercise Intervention in Pediatric Patients with Solid Tumors: The Physical Activity in Pediatric Cancer Trial","volume":"49","author":"Padilla","year":"2017","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1249\/MSS.0b013e3181c4dac1","article-title":"Exercise during hematopoietic stem cell transplant hospitalization in children","volume":"42","author":"Ruiz","year":"2010","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1643","DOI":"10.1002\/pbc.26038","article-title":"Investigation of the Effects of an Exercise Program on Physical Functions and Activities of Daily Life in Pediatric Hematopoietic Stem Cell Transplantation","volume":"63","author":"Kabak","year":"2016","journal-title":"Pediatric Blood Cancer"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Braam, K.I., van der Torre, P., Takken, T., Veening, M.A., van Dulmen-den Broeder, E., and Kaspers, G.J.L. (2016). Physical exercise training interventions for children and young adults during and after treatment for childhood cancer. Cochrane Database Syst. Rev., CD008796.","DOI":"10.1002\/14651858.CD008796.pub3"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1111\/sms.13545","article-title":"Inhospital exercise benefits in childhood cancer: A prospective cohort study","volume":"30","author":"Morales","year":"2020","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"12892","DOI":"10.1038\/s41598-020-69393-1","article-title":"Precision-basedexerciseas a new therapeutic option for children and adolescents with haematologicalmalignancies","volume":"10","author":"Lanfranconi","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1097\/NCC.0000000000000353","article-title":"Effects of Slow-Stroke Back Massage on Symptom Cluster in Adult Patients with Acute Leukemia: Supportive Care in Cancer Nursing","volume":"40","author":"Miladinia","year":"2017","journal-title":"Cancer Nurs."},{"key":"ref_22","unstructured":"World Health Organization (2010). Benchmarks for Training in Traditional\/Complementary and Alternative Medicine: Benchmarks for trining in Osteopathy, World Health Organization. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/44356."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1177\/1534735418796954","article-title":"Osteopathic Manipulative Treatment Effect on Pain Relief and QoL in Oncology Geriatric Patients: A Nonrandomized Controlled Clinical Trial","volume":"17","author":"Arienti","year":"2018","journal-title":"Integr. Cancer Ther."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"59","DOI":"10.2174\/1874205X01610010059","article-title":"Osteopathic Manual Treatment for Amyotrophic Lateral sclerosis: A Feasibility Pilot Study","volume":"10","author":"Maggiani","year":"2016","journal-title":"Open Neurol. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.math.2012.05.002","article-title":"Osteopathic manipulative treatment in obese patients with cronic low back pain: A pilot study","volume":"17","author":"Vismara","year":"2012","journal-title":"Man. Ther."},{"key":"ref_26","first-page":"321","article-title":"Osteopathic manipulative treatment in conjunction with medication relieves pain associated with fibromyalgia syndrome: Results of a randomized clinical pilot project","volume":"102","author":"Gamber","year":"2002","journal-title":"J. Am. Osteopath. Assoc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1089\/acm.2012.0354","article-title":"Osteopathic treatment of patients with long-term sequelae of whiplash injury: Effect on neck pain disability and QoL","volume":"19","author":"Schwerla","year":"2013","journal-title":"J. Altern. Complement. Med."},{"key":"ref_28","first-page":"596","article-title":"Associations of cytokine concentrations with key osteopathic lesions and clinical outcomes in patients with nonspecific chronic low back pain: Results from the osteopathic trial","volume":"112","author":"Licciardone","year":"2012","journal-title":"J. Am. Osteopath. Assoc."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Cicchitti, L., Martelli, M., and Cerritelli, F. (2015). Chronic inflammatory disease and osteopathy: A systematic review. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0121327"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.apmr.2015.08.424","article-title":"Proposed Criteria for Appraising Goal Attainment Scales Used as Outcome Measures in Rehabilitation Research","volume":"97","author":"Evans","year":"2016","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1177\/0962280218777896","article-title":"Statistical analysis of Goal Attainment Scaling endpoints in randomised trials","volume":"28","author":"Urach","year":"2019","journal-title":"Stat. Methods Med. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1016\/j.ejca.2007.04.015","article-title":"Long term survivors of childhood cancer: Cure and care. The ERICE Statement","volume":"43","author":"Haupt","year":"2007","journal-title":"Eur. J. Cancer"},{"key":"ref_33","unstructured":"Kendall, F.P., McCreary, E.K., Provance, P.G., Rodgers, M.M., and Romani, W.A. (2005). Muscle Testing and Function with Posture and Pain, Lippincott Williams e Wilkins. [5th ed.]."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/S1443-8461(03)80017-5","article-title":"A review of the physiology of cranial osteopathy","volume":"6","author":"Ferguson","year":"2003","journal-title":"J. Osteopath. Med."},{"key":"ref_35","first-page":"604","article-title":"Quantification of Motion Palpation","volume":"115","author":"Kasparian","year":"2015","journal-title":"J. Am. Osteopath. Assoc."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1177\/0269215508101741","article-title":"Writing SMART rehabilitation goals and achieving goal attainment scaling: A practical guide","volume":"23","year":"2009","journal-title":"Clin. Rehabil."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Chandrasekaran, S., Gui, C., Walsh, J.P., Lodhia, P., Suarez-Ahedo, C., and Domb, B.G. (2017). Correlation Between Changes in Visual Analog Scale and Patient-Reported Outcome Scores and Patient Satisfaction After Hip Arthroscopic Surgery. Orthop. J. Sports Med., 5.","DOI":"10.1177\/2325967117724772"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1159\/000499629","article-title":"Use of Complementary and Alternative Medicines among Cancer Patients: A Single-Center Study","volume":"97","author":"Gras","year":"2019","journal-title":"Oncology"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1089\/acm.2011.0022","article-title":"Use of Complementary Therapies for Cancer Symptom Management: Results of the 2007 National Health Interview Survey","volume":"18","author":"Anderson","year":"2012","journal-title":"J. Altern. Complement. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"3627","DOI":"10.1007\/s00520-018-4233-y","article-title":"The perceptions and experiences of osteopathic treatment among cancer patients in palliative care: A qualitative study","volume":"26","author":"Steel","year":"2018","journal-title":"Support. Care Cancer"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1007\/s003839900318","article-title":"Rotary atlanto-axial subluxation with torticollis following central-venous catheter insertion","volume":"16","author":"Brisson","year":"2000","journal-title":"Pediatr. Surg. Int."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1378\/chest.10-2133","article-title":"Pulmonary Outcomes in Survivors of Childhood Cancer A Systematic Review","volume":"140","author":"Hudson","year":"2011","journal-title":"Chest"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"S19","DOI":"10.1093\/annonc\/8.suppl_1.S19","article-title":"Long-term pulmonary sequelae after treatment of childhood Hodgkin\u2019s disease","volume":"8","author":"Bossi","year":"1997","journal-title":"Ann. Oncol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1002\/(SICI)1096-911X(199804)30:4<240::AID-MPO6>3.0.CO;2-G","article-title":"Risk factors for reduced pulmonary function after malignant lymphoma in childhood","volume":"30","author":"Nysom","year":"1998","journal-title":"Med. Pediatr. Oncol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1002\/pbc.21175","article-title":"Long-term pulmonary function in survivors of childhood Hodgkin disease and non-Hodgkin lymphoma","volume":"49","author":"Oguz","year":"2007","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1016\/j.apmr.2018.04.034","article-title":"The Association of Performance Status and Disease Severity in Patients with Chronic Graft-vs-Host Disease","volume":"100","author":"Andrews","year":"2018","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1152\/japplphysiol.00782.2009","article-title":"Role of skeletal muscles impairment and brain oxygenation in limiting oxidative metabolism during exercise after bed rest","volume":"109","author":"Porcelli","year":"2010","journal-title":"J. Appl. Physiol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.jpag.2005.09.001","article-title":"Adolescent Chronic Pelvic Pain","volume":"18","author":"Song","year":"2005","journal-title":"J. Pediatr. Adolesc. Gynecol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.ogc.2014.06.001","article-title":"The approach to chronic pelvic pain in the adolescent","volume":"41","author":"Powell","year":"2014","journal-title":"Obstet. Gynecol. Clin. N. Am."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1097\/NCC.0000000000000256","article-title":"Limitations in Ankle Dorsiflexion Range of Motion, Gait, and Walking Efficiency in Childhood Cancer Survivors","volume":"39","author":"Beulertz","year":"2016","journal-title":"Cancer Nurs."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1097\/NCC.0000000000000223","article-title":"Ankle Dorsiflexion in Childhood Cancer Patients: A Review of the Literature","volume":"38","author":"Beulertz","year":"2015","journal-title":"Cancer Nurs."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1002\/(SICI)1096-911X(199904)32:4<279::AID-MPO7>3.0.CO;2-T","article-title":"Limitation of ankle range of motion in survivors of acute lymphoblastic leukemia: A cross-sectional study","volume":"32","author":"Wright","year":"1999","journal-title":"Med. Pediatr. Oncol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1159\/000494809","article-title":"Skeletal Morbidity in Children and Adolescents During and Following Cancer Therapy","volume":"91","author":"Ward","year":"2019","journal-title":"Horm. Res. Paediatr."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1016\/S1470-2045(12)70274-7","article-title":"Children\u2019s Oncoogy Group. Effect of alternate-week versus continuous dexamethasone scheduling on the risk of osteonecrosis in paediatric patients with acute lymphoblastic leukaemia: Results from the CCG-1961 randomised cohort trial","volume":"13","author":"Mattano","year":"2012","journal-title":"Lancet Oncol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2340","DOI":"10.1182\/blood-2010-10-311969","article-title":"Pharmacokinetic, pharmacodynamic, and pharmacogenetic determinants of osteonecrosis in children with acute lymphoblastic leukemia","volume":"117","author":"Kawedia","year":"2011","journal-title":"Blood"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.pmr.2016.08.009","article-title":"Rehabilitation in Chronic Graft-Versus-Host Disease","volume":"28","author":"Smith","year":"2017","journal-title":"Phys. Med. Rehabil. Clin. N. Am."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1038\/bmt.2015.195","article-title":"Physical function and QoL in patients with chronic graft-versus-host-disease: A summary of preclinical and clinical studies and a call for exercise intervention trials in patients","volume":"51","author":"Borrell","year":"2016","journal-title":"Bone Marrow Transpl."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1182\/asheducation-2008.1.134","article-title":"Recognizing and managing chronic graft-versus-host disease","volume":"2008","author":"Lee","year":"2008","journal-title":"Hemat. Am. Soc. Hematol. Educ. Program"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1097\/MPH.0000000000001497","article-title":"Probiotic Supplementation Decreases Chemotherapy-induced Gastrointestinal Side Effects in Patients with Acute Leukemia","volume":"41","year":"2019","journal-title":"J. Pediatr. Hematol. Oncol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.critrevonc.2014.12.009","article-title":"Risk analysis, diagnosis and management of gastrointestinal mucositis in pediatric cancer patients","volume":"94","author":"Kuiken","year":"2014","journal-title":"Crit. Rev. Oncol.\/Hemat."},{"key":"ref_61","first-page":"280","article-title":"The effect of massage therapy on chemotherapy-induced nausea and vomiting in pediatric cancer","volume":"18","author":"Mazlum","year":"2013","journal-title":"Iran. J. Nurs. Midwifery Res."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Field, T. (2019). Pediatric Massage Therapy Research: A Narrative Review. Children, 6.","DOI":"10.3390\/children6060078"},{"key":"ref_63","unstructured":"Higgins, J.P.T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M.J., and Welch, V.A. (2021). Chapter 19: Adverse effects. Cochrane Handbook for Systematic Reviews of Interventions Version 6.2, Cochrane. Available online: www.training.cochrane.org\/handbook."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"e26924","DOI":"10.1002\/pbc.26924","article-title":"Exercise program for children and adolescents with leukemia and lymphoma during treatment: A comprehensive review","volume":"65","author":"Zucchetti","year":"2018","journal-title":"Pediatr. Blood Cancer"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/13\/24\/6321\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:49:54Z","timestamp":1760168994000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/13\/24\/6321"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,16]]},"references-count":64,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["cancers13246321"],"URL":"https:\/\/doi.org\/10.3390\/cancers13246321","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,16]]}}}