Reduced Neuroanatomic Volumes in Long-Term Survivors of Childhood Acute Lymphoblastic Leukemia

Abstract

Structural MRI of long-term survivors of childhood ALL demonstrated smaller volumes of multiple brain structures compared with healthy controls. Because of possible selection biases, these results must be interpreted with caution. Future studies are required to clarify the significance of these findings and the neurobiologic mechanisms involved.

Chemotherapy Pharmacodynamics and Neuroimaging and Neurocognitive Outcomes in Long-Term Survivors of Childhood Acute Lymphoblastic Leukemia

“…Although limited data are available on long-term outcomes in survivors of pediatric ALL treated according to contemporary chemotherapyonly protocols, our results are consistent with reports of processing speed deficits after chemotherapy 7 as well as of executive dysfunction in long-term survivors treated with chemotherapy and cranial radiation. 4,19,20 As adults, these long-term survivors have also demonstrated smaller volumes in cortical gray and white matter as well as in basal ganglia. 19,21 Our results extend these findings to contemporary protocols and functional brain activation and demonstrate a connection to plasma methotrexate exposure.…”

“…4,19,20 As adults, these long-term survivors have also demonstrated smaller volumes in cortical gray and white matter as well as in basal ganglia. 19,21 Our results extend these findings to contemporary protocols and functional brain activation and demonstrate a connection to plasma methotrexate exposure.…”

Educational attainment among long-term survivors of cancer in childhood and adolescence: a Norwegian population-based cohort study

“…In the 1970s and early 1980s, patients with leukaemia received prophylactic CNS-directed therapy in the form of radiation and intrathecal chemotherapy, while since the mid-1980s, only a minority has received prophylactic cranial irradiation. Patients with non-Hodgkin lymphoma generally received similar CNS prophylactic therapy as leukaemia patients, with a substantial decrease in the use of cranial irradiation since the early 1980s coupled with an optimization of systemic and intrathecal chemotherapy regimens [19][20][21]. The treatment protocols for all the other childhood cancers are assumed not to include CNS- …”

Cognitive Impairment in Survivors of Adolescent and Early Young Adult Onset Non-CNS Cancers: Does Chemotherapy Play a Role?

“…Although available studies are small and investigate specific cancer survivor groups, a growing body of data seems to correlate imaging abnormalities with objectively documented neurocognitive changes in some cancer survivor populations. [33][34][35][36][37][38][39][40][41] More expansive studies exploring the correlation between functional and structural imaging abnormalities and cognitive impairment may help to better describe subtle differences in impairment seen in different groups of cancer survivor populations and pinpoint the cause for these subtle changes. Various modalities such as functional magnetic resonance imaging, positron emission tomography scanning, neurophysiologic profiling, and serum biomarkers such as brain-derived neurotropic peptide may complement neuropsychological testing.…”