Psychological late effects of leukemia in children and their prevention

Schüler, D.; Polcz, Alaine; Révész, T; Koó, Rozália; Bakoš, M; Gál, Nóra Edit

doi:10.1002/mpo.2950090214

Cited by 18 publications

(7 citation statements)

References 6 publications

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“…Thus we have shown that the problem is related to treatment rather than psychosocial factors (Anderson et al, 1994). Dose of irradiation A number of previous studies have addressed the impact of high-or low-dose CRT, with little consensus with respect to findings (Trautman et al, 1988;Schuler et al, 1981;Appleton et al, 1990;Mulhern et al, 1992;Halberg et al, 1992;Hirsch et al, 1979). When our group 1 sample was subdivided into those who received a high dose (24 Gy) compared with a lower dose (18 Gy), it was found that the higher dose produced more adverse effects with regard to intellectual and educational abilities.…”

Section: Discussionmentioning

confidence: 76%

Risk factors for intellectual and educational sequelae of cranial irradiation in childhood acute lymphoblastic leukaemia

Smibert

Anderson²,

Godber³

et al. 1996

Br J Cancer

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Summary Long-term cognitive and educational sequelae have been inconsistently reported in children who received cranial irradiation (CRT) to prevent central nervous system (CNS) disease in acute lymphoblastic leukaemia (ALL). This study investigates a large and representative sample of survivors of ALL and compares them with non-irradiated survivors of cancer and healthy control children to determine the effect of CRT on cognitive and educational ability. Three groups of children were studied: Group 1 (n= 100) survivors of ALL treated with chemotherapy and CRT, group 2 (n = 50) children with a variety of malignancies treated with chemotherapy alone, group 3 (n = 100) healthy children. Cognitive and educational abilities of these groups were evalutated using standardised psychometric techniques. Significant differences in cognitive and educational abilities were found between the children in group 1 (chemotherapy + CRT) and the two control groups, with the children receiving CRT performing less well in a range of tests. Greatest differences were detected for tasks dependent on language function including verbal IQ, reading and spelling. Within group 1 a younger age at treatment (less than 5 years) and a higher dose of CRT (24 Gy vs 18 Gy) were predictive of poor long-term outcome for cognitive and education ability. In contrast, children who received chemotherapy alone, with or without intrathecal methotrexate, performed similarly to healthy controls. No gender differences were detected for these measures.

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Section: Discussionmentioning

confidence: 76%

Risk factors for intellectual and educational sequelae of cranial irradiation in childhood acute lymphoblastic leukaemia

Smibert

Anderson²,

Godber³

et al. 1996

Br J Cancer

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“…Secondly, the VIQ-PIQ discrepancy which has been observed by a number of investigators (Eiser, 1978(Eiser, , 1980Meadows et al, 1981;Schuler et al, 1981) has been thought to reflect a deficit in perceptuo-visuo-spatial functioning. However, as has been pointed out by Kagan (1982), the majority of subtests which comprise the PIQ are timed tests.…”

Section: Discussionmentioning

confidence: 97%

Attentional deficits in Long-term survivors of childhood acute lymphoblastic leukemia (ALL)

Brouwers¹,

Riccardi²,

Poplack³

et al. 1984

Journal of Clinical Neuropsychology

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Simple alerted auditory reaction time (SRT) behavior with various foreperiods was investigated in a group of long-term survivors of childhood ALL who were in continuous first remission. As part of therapy, the patients had received cranial irradiation and intrathecal chemotherapy to prevent the development of central nervous system leukemia. The patients were divided into three groups on the basis of CT brain scan findings: (1) those with normal CT scans (n = 10); (2) those with evidence of cortical atrophy (n = 8), and (3) those with intracerebral calcifications (n = 5). The SRT results indicated significant differences between patients with normal and abnormal CT scans. Specifically, patients with abnormal scans reacted slower, and this latency was exaggerated by increasing the length of the warning interval. Furthermore, they reacted with larger variability which increased with the prolongation of testing. Moreover, the severity of impairment was related to the type of CT-scan abnormality: patients with calcifications performed more poorly than patients with evidence of atrophy. The present results revealed a strong correlation between the presence and type of CT-scan abnormalities and attentional performance in long-term survivors of childhood ALL.

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“…An examination of the omitted studies indicates that their inclusion would not have changed the finding of a negative overall effect, although it may have affected its magnitude (with an unknown effect on moderator variables). Only one study (Schuler, Polcz, Revesz, Bakos & Gal, 1981) can be regarded as finding zero effect, on the basis that its subjects had a mean FIQ of 110. Seven of the others (numbers 22, 23, 25, 27, 28, 29 and 31 in Table 1) provide quite dear indications of FIQ decrements even if the authors report a "no effect" conclusion, and two (numbers 26 and 30) are indeterminate on FIQ although reporting more general adverse effects.…”

Section: Discussionmentioning

confidence: 99%

Cognitive Effects of Cranial Irradiation in Leukaemia: A Survey and Meta‐analysis

Cousens

Waters

Said

et al. 1988

Child Psychology Psychiatry

172

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Central nervous system (CNS) prophylaxis involving cranial irradiation has frequently been found to result in cognitive deficits in survivors of childhood acute lymphoblastic leukaemia. The existence of this effect is still controversial, however, as is the question of factors that might affect its severity. The literature is surveyed and a meta-analysis undertaken on 30 IQ comparisons, which shows a substantial average decrement in irradiated subjects. The effect is larger when radiation is administered at a younger age and appears to be progressive. The effect may comprise two elements, one common to young cancer patients and one specific to CNS prophylaxis.

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Psychological late effects of leukemia in children and their prevention

Cited by 18 publications

References 6 publications

Risk factors for intellectual and educational sequelae of cranial irradiation in childhood acute lymphoblastic leukaemia

Risk factors for intellectual and educational sequelae of cranial irradiation in childhood acute lymphoblastic leukaemia

Attentional deficits in Long-term survivors of childhood acute lymphoblastic leukemia (ALL)

Cognitive Effects of Cranial Irradiation in Leukaemia: A Survey and Meta‐analysis

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