A meta-analysis of the neuropsychological sequelae of chemotherapy-only treatment for pediatric acute lymphoblastic leukemia.
BACKGROUND
Mixed findings on the neuropsychological sequelae of chemotherapy-only treatment for pediatric acute lymphoblastic leukemia (ALL), without radiation, indicate the need for a comprehensive meta-analytic review. The purpose of the current study was to conduct a meta-analysis assessing neuropsychological and academic functioning differences between children with ALL treated solely with chemotherapy and comparison groups.


METHODS
Thirteen articles met inclusion criteria for the meta-analysis and were analyzed using a random effects model, weighted least squares methods.


RESULTS
Mean effect sizes were significantly different from zero for multiple domains of intelligence and academic achievement; processing speed; verbal memory; and some aspects of executive functioning and fine motor skills, indicating worse functioning in ALL survivors. Effect sizes for visual-motor skills and visual memory were not significantly different from zero.


CONCLUSIONS
Results support the presence of neuropsychological and academic sequelae for ALL survivors treated solely with chemotherapy and highlight the need for ongoing follow-up of children with ALL using a standardized neuropsychological test battery and research methodology.
Peterson
Catherine C
CC
Division of Child Behavioral Health, Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Michigan, USA. catpeter@med.umich.edu
Johnson
Courtney E
CE
Ramirez
Lisa Y
LY
Huestis
Samantha
S
Pai
Ahna L H
AL
Demaree
Heath A
HA
Drotar
Dennis
D
D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders; D005260:Female; D006801:Humans; D007223:Infant; D007360:Intelligence; D007859:Learning Disabilities; D008297:Male; D015233:Models, Statistical; D009422:Nervous System Diseases; D009483:Neuropsychological Tests; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy
D000970:Antineoplastic Agents