Long-term psychological effects of childhood leukemia and its treatment.
We report the results of a 5-year follow-up of the cognitive development of 19 survivors of acute lymphoblastic leukemia, all of whom received 24 Gy cranial irradiation and a course of intrathecal methotrexate. Assessment was made before radiotherapy and annually thereafter. Cognitive impairment was found to be transient in children who did not manifest somnolence who were under 5 years at the time of treatment. Despite having normal IQs and normal CT scans, 9 of 18 survivors in continuous complete remission were having learning problems at school 5 years after diagnosis. Assessment of their intellectual and memory functions revealed that as compared with matched healthy children, patients had lowered IQs but also had a specific auditory learning deficit independent of IQ. Long-term memory was found to be impaired for verbal auditory but not for verbal visual material. Results are discussed in terms of possible remediation of the learning disability.
Jannoun
L
L
Hospital for Sick Children, London, England.
Chessells
J M
JM
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology*; D003131:Combined Modality Therapy / Q000009:adverse effects; D016371:Cranial Irradiation / Q000009:adverse effects*; D002658:Developmental Disabilities / Q000209:etiology*; D006970:Disorders of Excessive Somnolence / Q000209:etiology; D004521:Educational Measurement; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007360:Intelligence; D007859:Learning Disabilities / Q000209:etiology; D008297:Male; D008569:Memory Disorders / Q000209:etiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000523:psychology* / Q000532:radiotherapy; D011581:Psychological Tests