Chemotherapeutic CNS prophylaxis and neuropsychologic change in children with acute lymphoblastic leukemia: a prospective study.
OBJECTIVE
To determine whether prophylactic CNS chemotherapy for childhood acute lymphoblastic leukemia is associated with declines in neuropsychological abilities.


METHODS
Growth curve analysis was used to examine neuropsychological outcome and treatment-related change in children (N = 30) who were treated at two childhood cancer centers. A comprehensive test battery was administered at baseline (8 months), 2, 3, and 4 years postdiagnosis (age at diagnosis M = 5.90 years, SD = 4.2C).


RESULTS
Results indicated modest declines in arithmetic, visual motor integration, and verbal fluency. Intrathecal and systemic treatment was related to poorer visual motor integration at 4 years postdiagnosis and a faster rate of decline in visual motor integration skills across the observation period than intrathecal treatment alone. Arithmetic proficiency at 4 years after diagnosis was related to maternal education, but the rate of decline was not. Verbal fluency was unrelated to demographic or treatment variables.


CONCLUSIONS
These findings suggest that neuropsychological outcome and declines are related to both demographic and treatment characteristics depending on the cognitive domain examined.
Espy
K A
KA
Department of Psychiatry, Southern Illinois University, Carbondale, IL 62901-6503, USA. kespy@siumed.edu
Moore
I M
IM
Kaufmann
P M
PM
Kramer
J H
JH
Matthay
K
K
Hutter
J J
JJ
D000970:Antineoplastic Agents / Q000009:adverse effects*; D001921:Brain / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D003071:Cognition / Q000187:drug effects*; D005260:Female; D006801:Humans; D007223:Infant; D007278:Injections, Spinal; D016014:Linear Models; D008297:Male; D009483:Neuropsychological Tests; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000187:drug effects*; D016896:Treatment Outcome; D014705:Verbal Behavior / Q000187:drug effects*
D000970:Antineoplastic Agents