Attention and information processing in survivors of childhood acute lymphoblastic leukemia treated with chemotherapy only.
BACKGROUND
Omitting radiotherapy for central nervous system (CNS) prophylaxis has improved the overall quality of life for long-term survivors of childhood acute lymphoblastic leukemia (ALL). However, recent reports suggest minor cognitive impairment in survivors who received chemotherapy only.


METHODS
This study focused on attentional functioning and speed of information processing in 23 children previously treated for ALL according to EORTC 58881 and EORTC 58951 protocol. Patients received intrathecal methotrexate combined with high doses intravenous methotrexate as CNS prophylaxis. Cognitive functioning was assessed with the Amsterdam Neuropsychological Tasks, a computerized attention assessment program. Variables of both speed and accuracy of the patients were compared with those obtained from 23 age- and sex-matched control children.


RESULTS
Patients were equal to control children concerning baseline speed, sustained attention, response inhibition, and response organization. However, they were significantly slower than controls in three tasks: encoding, memory search letters, and focused attention 4-letters. Interactions with the difficulty of the task were found. There were no differences in number or type of errors between groups on all tasks.


CONCLUSIONS
ALL survivors treated with chemotherapy have specific information processing difficulties. They process information slower than control children, especially when more information has to be processed or when attention has to be focused precisely. In spite of being slower, patients are equally accurate compared to control children.
Mennes
Maarten
M
Laboratory for Neuropsychology, Department of Paediatrics, Catholic University of Leuven, Belgium.
Stiers
Peter
P
Vandenbussche
Erik
E
Vercruysse
Gertrui
G
Uyttebroeck
Anne
A
De Meyer
Geert
G
Van Cool
Stefaan W
SW
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001288:Attention; D016543:Central Nervous System Neoplasms / Q000517:prevention & control*; D002648:Child; D003072:Cognition Disorders / Q000209:etiology / Q000517:prevention & control; D000075202:Contraindications; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D008606:Mental Processes; D008727:Methotrexate / Q000008:administration & dosage; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000188:drug therapy* / Q000523:psychology*; D011581:Psychological Tests; D011878:Radiotherapy; D017741:Survivors
D000970:Antineoplastic Agents; D008727:Methotrexate