Physical Activity to Modify Sequelae and Quality of Life in Childhood Acute Lymphoblastic Leukemia

An advanced practice nurse (APN) will meet twice weekly with the patient and family for the
first 4 weeks of the intervention to initiate the motivation-based dialogue and therapeutic
interaction; this will be followed by once weekly visits during weeks 5-8 of the
intervention; and monthly visits during weeks 9-through end of therapy. The physical
therapist (PT) will meet at least once weekly with the patient and family during weeks 1-4
to initiate the prescriptive tailored exercise program; subsequent visits to reinforce and
modify the program will occur at least once every other week during weeks 5-8, and at least
once monthly during weeks 9-135 of the intervention. The PT will visit at least once weekly
during weeks 1-4, at least once every other week during weeks 5-8, and at least once monthly
during weeks 9-135. During weeks 9-135 of the intervention, the APN will call between the
monthly in person-visits, if needed to those randomized to the MAP group to assure fidelity
to the intervention and to provide booster support to the intervention where needed.

Inclusion Criteria:

1. An immunophenotypic diagnosis of non-B cell ALL

2. Age 4 years through <19 years at diagnosis

3. 2-8 days on or per front line ALL treatment protocol

4. One parent or legal guardian (≥ 18 years) of the study subject who speaks and
understands the English Language

5. Participant speaks and understands the English language

6. Written informed consent and child assent

Exclusion Criteria:

1. Age < 4 years or ≥19 years at diagnosis

2. A diagnosis of cerebral palsy or down syndrome

3. Second malignancy, chromosome breakage syndrome, or severe congenital
immunodeficiency

4. Inability or unwillingness of research participant or legal guardian/representative
to give written informed consent/assent

5. Females who are pregnant.