title: Parental reports of behavioural outcome among paediatric leukaemia survivors in Malaysia: a single institution experience.
abstract: OBJECTIVE
  To determine the behavioural impact of chemotherapy in survivors of acute lymphoblastic leukaemia (ALL) treated with chemotherapy only and to identify treatment-related or sociodemography-related factors that might be associated with behavioural outcome.
  
  
  METHODS
  We examined 57 survivors of childhood ALL, who were off treatment for at least 2 years and were in remission, aged 4-18 years, and 221 unrelated healthy controls. The Child Behaviour Checklist (CBCL) parent report was used either in English or in Bahasa Malaysia (the national language of Malaysia) to assess the behavioural outcome.
  
  
  RESULTS
  Childhood ALL survivors had significantly higher scores on externalising behaviour on the CBCL parent report than did controls. Higher problem scores were found in ALL survivors with single parents on 'total problems' (P = 0.03) and subscales 'withdrawn' (P = 0.03), 'social problems' (P < 0.01) and 'delinquent behaviour' (P = 0.03) than in survivors with married parents. Significant associations were seen between a lower education level of the father and the variables representing internalising (withdrawn, anxious/depressed) and externalising (aggressive behaviour). We observed trends on higher scores in all scales in ALL survivors with single parents than in controls with single parents or with fathers with low education level, especially primary education only.
  
  
  CONCLUSIONS
  Malaysian childhood ALL survivors had a significantly increased risk for externalising behavioural problems, and there was a trend towards increased risk of problems in many other behavioural scales. Understanding the sociocultural dimension of patients' health is important to be able to design the most appropriate remedy for problem behaviours detected in this multi-ethnic population.
authors.affiliation: Department of Pediatrics, National University of Malaysia, Kuala Lumpur, Malaysia.
authors.forename: Alias
authors.initials: A
authors.lastname: Hamidah
authors.forename: Mohd
authors.initials: M
authors.lastname: Sham Marina
authors.forename: Azmi M
authors.initials: AM
authors.lastname: Tamil
authors.forename: C-Khai
authors.initials: CK
authors.lastname: Loh
authors.forename: Latiff A
authors.initials: LA
authors.lastname: Zarina
authors.forename: Rahman
authors.initials: R
authors.lastname: Jamal
authors.forename: Mohd Daud
authors.initials: MD
authors.lastname: Tuti Iryani
authors.forename: Vijayalakshmi C
authors.initials: VC
authors.lastname: Ratnam
mesh_terms: D000293:Adolescent; D000374:Aggression; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001007:Anxiety; D016022:Case-Control Studies; D002648:Child; D002652:Child Behavior; D002653:Child Behavior Disorders; D002675:Child, Preschool; D003863:Depression; D004522:Educational Status; D005220:Fathers; D005260:Female; D006801:Humans; D008296:Malaysia; D008297:Male; D010290:Parents; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D015406:Single Parent; D011795:Surveys and Questionnaires; D017741:Survivors
chemical_list: D000970:Antineoplastic Agents
keywords: Leucemia aguda; Malaisie; Malasia; Malaysia; Supervivientes; acute leukaemia; behavioural outcome; leucémie aiguë; resultados conductuales; résultat comportemental; survivants; survivors