Central nervous system-directed therapy in the treatment of childhood acute lymphoblastic leukemia and studies of neurobehavioral outcome: Children's Cancer Group trials.
Long-term survival rates in childhood acute lymphoblastic leukemia (ALL) have improved due, in part, to the introduction and subsequent refinements in central nervous system (CNS)-directed therapy. Studies of cognitive, motor, and behavioral functioning, which characterize the patterns and severity of CNS sequelae, are being used increasingly as measurable treatment endpoints. This paper summarizes the advances in CNS-directed therapy derived from Children's Cancer Group randomized therapeutic trials. Results from neurobehavioral outcome studies built upon these trials are also presented. A section of this review is focused on CNS-directed treatments and the neurodevelopmental outcomes of infants diagnosed with ALL, an especially high-risk patient subset. Future studies of neurobehavioral outcome are briefly elaborated in the context of current chemotherapy approaches used in the treatment of childhood ALL.
Kaleita
Thomas A
TA
Department of Psychiatry and Biobehavioral Sciences and The UCLA Neuro-Oncology Program, UCLA School of Medicine, 300 Medical Plaza, Los Angeles, CA 90095-6967, USA. tkaleit a@ucla.edu
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016543:Central Nervous System Neoplasms / Q000523:psychology / Q000628:therapy*; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D018572:Disease-Free Survival; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000523:psychology / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D016896:Treatment Outcome