# Associations Between Physical Activity, Fitness, Perceived Health, Chronic Disease and Mortality in Adult Survivors of Childhood and Young Adult Hodgkin’s Lymphoma: A Scoping Review

## TL;DR

Adult survivors of Hodgkin’s lymphoma have higher risks of chronic diseases and lower physical activity and fitness compared to the general population, with radiotherapy exposure linked to worse health outcomes.

## Contribution

This scoping review identifies specific associations between physical activity, fitness, and chronic disease risks in adult survivors of childhood and young adult Hodgkin’s lymphoma.

## Key findings

- Adult HL survivors report lower physical activity and fitness levels compared to the general population.
- Thoracic and neck radiotherapy is consistently linked to poor fitness, body composition, and autonomic dysfunction.
- Survivors face higher risks of chronic disease and mortality, with perceived health and body composition abnormalities being common.

## Abstract

Adult survivors of childhood and young adult Hodgkin’s lymphoma (HL) remain at a higher risk than the general population for moderate to life-threatening chronic health conditions (CHCs) including cardiac, vascular, endocrine and pulmonary impairments. Regular physical activity (PA) can improve physical fitness, reducing the risk of severity for CHCs. However, it is unclear whether adult survivors of HL experience the same benefits from PA as their peers. A scoping review was conducted to describe the associations between PA, physical fitness, perceived health, chronic disease and mortality in this population. In comparison to the general population, adult survivors of HL reported lower PA levels, had lower physical fitness and were more likely to have abnormalities in body composition and perceived health, autonomic dysfunctions and a higher risk of chronic disease and mortality than controls. An exposure to thoracic and neck radiotherapy seemed to be consistently associated with poor fitness and body composition, physical inactivity and autonomic dysfunctions.

Background/Objectives: Adult survivors of childhood and young adult Hodgkin’s lymphoma (HL) are at a higher risk than the general population for moderate to life-threatening chronic health conditions (CHCs) including cardiac, vascular, endocrine and pulmonary impairments. Regular physical activity (PA) can improve physical fitness, reducing the risk of severity for CHCs. However, it is unclear whether adult survivors of HL experience the same benefits from PA as their peers. This scoping review aims to describe the associations between PA, physical fitness, perceived health, chronic disease and mortality in adult survivors of HL. In addition, body composition, autonomic dysfunction and associated treatment-related risk factors were included. Methods: MEDLINE (via PubMed), Web of Science, CINAHL and Cochrane databases were searched for potential studies that involved PA or physical fitness and outcomes such as body composition, autonomic dysfunction, associated treatment-related risk factors, associated chronic disease/mortality or perceived health. Results: A total of 2886 records were retrieved. After screening, 20 studies were included for review. In comparison to the general population, adult survivors of HL reported lower PA levels and had lower physical fitness. In addition, survivors were more likely to have abnormalities in body composition (i.e., reduced bone mineral density) and perceived health, autonomic dysfunctions and a higher risk of chronic disease and mortality than controls. An exposure to thoracic and neck radiotherapy seemed to be consistently associated with poor fitness (i.e., reduced muscle strength, lower cardiopulmonary fitness) and body composition, physical inactivity and autonomic dysfunctions. Conclusions: Interventional studies are needed to determine the maximum effective doses of PA regarding frequency, intensity, time, type, volume and progression (exercise prescription principles) that best optimize cardiovascular adaptations and health benefits in adult survivors of HL.