[Assessment of congitive functions in patients post acute lymphoblastic leukemia treatment used P300 event related potential].
BACKGROUND
Acute Lymphoblastic Leukaemia (ALL) and its treatment can be involved in generation of cognitive function disorders. Assessment and monitoring of this side effect can be performed by endogenous evoked potential P300. The aim of the study was to show the changes of P300 potential in patients after ALL treatment.


METHODS
There were 36 children admitted to P300, but 3 of them were unable to perform it because of developmental delay and one child due to attention deficits. The study was performed on 32 patients with no influence on cognitive functions, aged 6 to 22 years (average 14,2), 13 girls and 19 boys, after ALL treatment finished before 0,3 to 11 years ago (average 3,2 years). The patients were divided into 3 groups, 9 children treated with New York program, 7 with older BFM program with chemio and radiotherapy of CNS, and 16 children with BFM 95 without radiotherapy. In the control group there were 20 persons aged 11-18 (average 14,1 years), consulted in the Neuropediatric Out-patient Clinic. P300 evoked potentials were performed due to IFCN recommendations. Latency, amplitude of P300 and time reaction were assessed with U Mann-Whitney test.


RESULTS
The children treated with older BFM programs had significant lower onset age of disease, and the age of P300 data was higher than other. Time reaction was shorter in this group. There were no significant differences between latency and amplitude of P300 in comparison to control group. Patient with NY and BFM 95 programmes had normal latency, but amplitude of P300 was significantly lower than in control group and time reaction was non-significantly longed. Patients with additional radiotherapy of CSN (NY and BFM) in the moment of assessment were older. The amplitude of P300 was significantly lower and latency similar to these parameters in control group. The statistic analyses were performed to eliminate the age influence on latency. The mean age of control group was established as 13,5 years with correction of 10ms per year to this age for each patient. There was no statistic significance in these groups even though the difference in children with radiotherapy was nearly statistical.


CONCLUSIONS
1. It is important to establish new, less toxic ALL treatment programs, because of significant cognitive impairment in 11% of examined children. 2. The mild modification of ALL treatment programs is necessary due to observation of decreased of P300 amplitude, what may influence education abilities.
Kroczka
Slawomir
S
Klinika Neurologii Dzieciecej, Pracownia Neurofizjologii KND, Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie. neupedkr@cm-uj.krakow.pl
Steczkowska-Klucznik
Małgorzata
M
Kaciński
Marek
M
Skoczeń
Szymon
S
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D002648:Child; D003071:Cognition; D003072:Cognition Disorders / Q000139:chemically induced / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology*; D018913:Event-Related Potentials, P300; D005072:Evoked Potentials, Auditory; D005260:Female; D006801:Humans; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D011877:Radionuclide Imaging; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D011930:Reaction Time; D018709:Statistics, Nonparametric