title: Intellectual development after treatment in children with acute leukemia and brain tumor.
abstract: BACKGROUND
  The influence of central nervous system (CNS)-directed chemotherapy on intelligence remains controversial. In this study, we investigated the influence of treatment on intellectual development in acute lymphoblastic leukemia (ALL) and brain tumor patients undergoing CNS-directed treatments.
  
  
  METHODS
  Among patients treated in the Department of Pediatrics, St Luke's International Hospital between April 2000 and March 2009, the subjects were 38 patients with ALL or brain tumors who underwent regular Wechsler intelligence tests.
  
  
  RESULTS
  The subjects consisted of 26 patients with ALL and 12 with brain tumors. Prophylactic cranial irradiation was not performed in patients with ALL, whereas it was done for all those with brain tumor. In patients with ALL, the IQ 1 year later was not changed from the start of treatment. In those with brain tumors, the verbal IQ 1 year later was significantly lower than that at the start of treatment. In patients with ALL, intelligence tests were performed 3 years after the start of treatment and there were no marked changes between the two time-points (n = 11). In those with a brain tumor, intellectual functions further decreased after the completion of treatment to as late as 5 years after the initiation of treatment (n = 7).
  
  
  CONCLUSIONS
  There is no intellectual impairment in any patient with ALL at post-treatment follow-up 3 years after the start of treatment, while intelligence is serially reduced in brain tumor patients. An innovative intervention may be needed for this group of patients.
authors.affiliation: Departments of PediatricsPharmacyClinical Psychology, St Luke's International HospitalDepartment of Practical Pharmacy, Faculty of Pharmacy, Keio University, Tokyo, Japan.
authors.forename: Shizuka
authors.initials: S
authors.lastname: Watanabe
authors.affiliation: Departments of PediatricsPharmacyClinical Psychology, St Luke's International HospitalDepartment of Practical Pharmacy, Faculty of Pharmacy, Keio University, Tokyo, Japan.
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Azami
authors.affiliation: Departments of PediatricsPharmacyClinical Psychology, St Luke's International HospitalDepartment of Practical Pharmacy, Faculty of Pharmacy, Keio University, Tokyo, Japan.
authors.forename: Miwa
authors.initials: M
authors.lastname: Ozawa
authors.affiliation: Departments of PediatricsPharmacyClinical Psychology, St Luke's International HospitalDepartment of Practical Pharmacy, Faculty of Pharmacy, Keio University, Tokyo, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kamiya
authors.affiliation: Departments of PediatricsPharmacyClinical Psychology, St Luke's International HospitalDepartment of Practical Pharmacy, Faculty of Pharmacy, Keio University, Tokyo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hasegawa
authors.affiliation: Departments of PediatricsPharmacyClinical Psychology, St Luke's International HospitalDepartment of Practical Pharmacy, Faculty of Pharmacy, Keio University, Tokyo, Japan.
authors.forename: Chitose
authors.initials: C
authors.lastname: Ogawa
authors.affiliation: Departments of PediatricsPharmacyClinical Psychology, St Luke's International HospitalDepartment of Practical Pharmacy, Faculty of Pharmacy, Keio University, Tokyo, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ishida
authors.affiliation: Departments of PediatricsPharmacyClinical Psychology, St Luke's International HospitalDepartment of Practical Pharmacy, Faculty of Pharmacy, Keio University, Tokyo, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Hosoya
authors.affiliation: Departments of PediatricsPharmacyClinical Psychology, St Luke's International HospitalDepartment of Practical Pharmacy, Faculty of Pharmacy, Keio University, Tokyo, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Kizu
authors.affiliation: Departments of PediatricsPharmacyClinical Psychology, St Luke's International HospitalDepartment of Practical Pharmacy, Faculty of Pharmacy, Keio University, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Manabe
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003071:Cognition; D016371:Cranial Irradiation / Q000009:adverse effects; D005260:Female; D006801:Humans; D007360:Intelligence / Q000187:drug effects / Q000528:radiation effects; D008297:Male; D009483:Neuropsychological Tests; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D011379:Prognosis; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents