Background: As the survival rates of pediatric malignancies
increased, many survivors experienced various long-term effects.
Cognitive dysfunction may be one of the hazardous late effects among
this critical age group. This study aimed to evaluate the cognitive
functions, brain volume, and risk factors affecting them among survivors
of hematological malignancies. Methods: This case-control study was
conducted on 68 survivors of hematological malignancies, with a mean
follow-up period 2.1± 1.2 years (ranged from 1 to 6.2 years). Age and
sex-matched 68 child were selected as a comparison group. Detailed
clinical and therapeutic data were collected from patients’ records.
Assessment of cognitive function was done using Arabic version of the
Stanford-Binet Test (version IV). Quantitative volumetric assessment of
the brain was done using the NeuroQuant study (NQ). Results: The cancer
survivors showed significantly lower levels in IQ and their subitems
than the control group. Brain atrophy was observed in the NQ impression
in the majority of our survivors. AML survivors had significantly lower
volumes of thalami, white matter, and hippocampus than other survivors.
Many risk factors had a significantly adverse effect on different IQ
subitems, such as radiotherapy (RTH), high cumulative doses of
methotrexate (MTX), and prednisone. While low white matter volume (WMV)
was observed with higher mean cumulative doses of MTX and
anthracyclines. Conclusions: Survivors of pediatric hematological
malignancies showed significant cognitive impairment, this can be
attributed to neuronal degeneration (brain volume loss). RTH, high
cumulative doses of MTX and steroids were the most prominent risk
factors.
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