Academic career after treatment for acute lymphoblastic leukaemia.
OBJECTIVE
To evaluate academic career in long term survivors of childhood acute lymphoblastic leukaemia (ALL), in comparison to their healthy siblings.


METHODS
Ninety four children treated for ALL with cranial irradiation 18 or 25 Gy and intrathecal methotrexate as CNS prophylaxis. Median age at evaluation was 20 years; median follow up since diagnosis was 15 years at the time of the study.


METHODS
Patients and their 134 siblings completed a questionnaire on school career. The percentage of referrals to special primary schools for learning disabled, and the final level of secondary education in patients and siblings were compared, using a six point classification. Within the patient group, the effect of possible risk factors (age at diagnosis, irradiation dose, and gender) was investigated.


RESULTS
Significantly more patients than siblings were placed in special educational programmes. A significant difference was found for level of secondary education. No effect of gender or irradiation dose was found, but younger age at diagnosis was significantly related to both referrals and school levels.


CONCLUSIONS
Treatment for childhood ALL with cranial irradiation and chemotherapy at a young age is clearly associated with poorer academic career.
Kingma
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Children's Cancer Center, Department of Pediatrics, University Hospital of Groningen, PO Box 30.001, 9700 RB Groningen, Netherlands. W.A.Kamps@medrug.nl
Rammeloo
L A
LA
van Der Does-van den Berg
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A
Rekers-Mombarg
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L
Postma
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A
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D016371:Cranial Irradiation / Q000009:adverse effects; D004519:Education, Special / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008727:Methotrexate / Q000009:adverse effects; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000532:radiotherapy / Q000534:rehabilitation*; D011879:Radiotherapy Dosage; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D017741:Survivors
D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate