title: Symptoms of attention-deficit/hyperactivity disorder in long-term survivors of childhood leukemia.
abstract: BACKGROUND
  Survivors of childhood acute lymphoblastic leukemia (ALL) sometimes have clinical features that suggest attention-deficit/hyperactivity disorder (ADHD), though few studies have examined specific symptoms in survivors.
  
  
  METHODS
  Long-term survivors of childhood ALL (n = 161) received a neurological examination, while parents completed rating scales to establish formal criteria for ADHD. Symptom profiles were generated and compared across demographic and treatment characteristics, as well as medical tests associated with brain pathology.
  
  
  RESULTS
  Prevalence rates of ADHD were similar in survivors (10.5%) compared to those reported in the general population (7-10%). However, 25.5% of survivors reported symptoms that impair functioning in multiple settings, with attention problems being most common. These symptoms were associated with cranial radiation therapy (CRT) (mean inattentive symptoms [SD] = 3.6 [3.19] for group treated with CRT vs. 1.6 [2.40] for non-CRT group, P = 0.0006), and survivors who demonstrated impaired anti-saccades during the neurologic exam (mean inattentive symptoms [SD] = 3.4 [3.29] for those with impaired anti-saccades vs. 1.4 [2.41] for those with normal anti-saccades; P = 0.0004).
  
  
  CONCLUSIONS
  The presence of a neurologically-based phenotype of attention problems in survivors of leukemia that is not fully captured by the syndrome of ADHD suggests that treatments specific to childhood ALL should be explored.
authors.affiliation: Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee, USA. kevin.krull@stjude.org
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Krull
authors.forename: Raja B
authors.initials: RB
authors.lastname: Khan
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Ness
authors.forename: Davonna
authors.initials: D
authors.lastname: Ledet
authors.forename: Liang
authors.initials: L
authors.lastname: Zhu
authors.forename: Ching-Hon
authors.initials: CH
authors.lastname: Pui
authors.forename: Scott C
authors.initials: SC
authors.lastname: Howard
authors.forename: Deo Kumar
authors.initials: DK
authors.lastname: Srivastava
authors.forename: Noah D
authors.initials: ND
authors.lastname: Sabin
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Hudson
authors.forename: E Brannon
authors.initials: EB
authors.lastname: Morris
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology* / Q000209:etiology*; D002648:Child; D016371:Cranial Irradiation / Q000009:adverse effects; D005260:Female; D006801:Humans; D007938:Leukemia / Q000150:complications* / Q000628:therapy; D008297:Male; D009460:Neurologic Examination; D015995:Prevalence; D017741:Survivors / Q000523:psychology*; D055815:Young Adult