title: Intellectual development of childhood ALL patients: a multicenter longitudinal study.
abstract: In childhood acute lymphoblastic leukemia (ALL), radiotherapy for CNS prophylaxis is not used in frontline therapy anymore. Standard treatment for ALL nowadays consists of polychemotherapy. Therefore, assessment of potential chemotherapy-induced cognitive side effects becomes important. Although neurotoxicity was demonstrated in cross-sectional studies, longitudinal studies remain scarce.
  
  
  
  We evaluated intellectual development of 94 pediatric ALL patients between 1990 and 1997, diagnosed before the age of 12 years, treated according to the European Organisation for Research and Treatment of Cancer Children's Leukemia Group 58881 protocol. Three assessments of the Wechsler Intelligence Scale for Children Revised were performed since diagnosis, according to age. Using repeated measures regression analysis, we investigated the effect of gender (low versus increased) risk group, parents' education, age at diagnosis, intelligence quotient (IQ) subscale (verbal (VIQ) versus performance (PIQ) intelligence), and test session.
  
  
  
  PIQ scores were lower than VIQ at baseline (-5.3 points on average, p = 0.0032), yet PIQ increased more strongly (PIQ: +3.9 points per test session; VIQ: +0.8, p = 0.0079), so this baseline difference disappeared (p = 0.0079). There were no clear effects of gender (girls: +0.6 points; p = 0.78) or risk group (low risk: +1.5 points; p = 0.49), but IQ scores were higher when one parent had followed higher education (+9.5 points, p < 0.0001). Finally, diagnosis at younger age predicted lower IQ scores (-1.3 points per year, p = 0.0009).
  
  
  
  Given that IQ scores did not decline, our findings demonstrate a stable pattern. However, the lower PIQ scores at baseline may indicate that performance functioning is vulnerable to acute neurotoxicity. Also, lower scores for younger patients highlight the stronger impact of the disease and/or treatment at younger age.Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: University Hospitals Leuven, Department of Pediatric Hematology and Oncology, Leuven, Belgium.|KU Leuven, Department of Development and Regeneration, Leuven, Belgium.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Sleurs
authors.affiliation: University Hospitals Leuven, Department of Pediatric Hematology and Oncology, Leuven, Belgium.
authors.forename: Jurgen
authors.initials: J
authors.lastname: Lemiere
authors.affiliation: University Hospitals Leuven, Department of Pediatric Hematology and Oncology, Leuven, Belgium.
authors.forename: Trui
authors.initials: T
authors.lastname: Vercruysse
authors.affiliation: Ghent University Hospital, Department of Pediatric Hematology and Oncology, Ghent, Belgium.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Nolf
authors.affiliation: KU Leuven, Department of Development and Regeneration, Leuven, Belgium.
authors.forename: Ben
authors.initials: B
authors.lastname: Van Calster
authors.affiliation: University Hospitals Leuven, Department of Radiology, Leuven, Belgium.|KU Leuven, Department of Imaging and Pathology, Leuven, Belgium.
authors.forename: Sabine
authors.initials: S
authors.lastname: Deprez
authors.affiliation: University Hospitals Leuven, Department of Pediatric Hematology and Oncology, Leuven, Belgium.
authors.forename: Marleen
authors.initials: M
authors.lastname: Renard
authors.affiliation: Ghent University Hospital, Department of Pediatric Hematology and Oncology, Ghent, Belgium.
authors.forename: Els
authors.initials: E
authors.lastname: Vandecruys
authors.affiliation: Ghent University Hospital, Department of Pediatric Hematology and Oncology, Ghent, Belgium.
authors.forename: Yves
authors.initials: Y
authors.lastname: Benoit
authors.affiliation: University Hospitals Leuven, Department of Pediatric Hematology and Oncology, Leuven, Belgium.|KU Leuven, Department of Development and Regeneration, Leuven, Belgium.
authors.forename: Anne
authors.initials: A
authors.lastname: Uyttebroeck
mesh_terms: D000293:Adolescent; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D003071:Cognition; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007360:Intelligence; D007361:Intelligence Tests; D008137:Longitudinal Studies; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000503:physiopathology*; D014888:Wechsler Scales
keywords: acute lymphoblastic leukemia; cancer; development; intelligence; oncology; performance versus verbal intelligence