title: Association between dehydroepiandrosterone-sulfate and attention in long-term survivors of childhood acute lymphoblastic leukemia treated with only chemotherapy.
abstract: Long-term survivors of childhood acute lymphoblastic leukemia (ALL) are at risk for neurocognitive impairment, as well as compromised hypothalamic-pituitary-adrenal (HPA) function. Dehydroepiandrosterone-sulfate (DHEAS) is an adrenal androgen commonly used as a marker of HPA function. In the general population, a low level of DHEAS has been associated with poorer cognition. At ≥2years post-treatment, we examined the association of DHEAS with attention outcomes in 35 male and 34 female long-term survivors of childhood ALL (mean[standard deviation] age at evaluation 14.5[4.7] years; 7.5[1.9] years post-diagnosis) who were treated with only chemotherapy and without prophylactic cranial irradiation. Male survivors with low-normal levels of DHEAS had worse performance than male survivors with high levels of DHEAS on multiple measures of attention (all P's<0.05). However, association between DHEAS and attention measures were not found in female survivors. Our results suggest that survivors of ALL who suffer from partial but persistent adrenal insufficiency may be at risk for neurocognitive deficits. This finding should be validated in a larger prospective study, with attention to sex differences in the potential impact of adrenal insufficiency on neurocognitive outcomes.
authors.affiliation: Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, USA.
authors.forename: Yin Ting
authors.initials: YT
authors.lastname: Cheung
authors.affiliation: Department of Endocrinology, St Jude Children's Research Hospital, Memphis, USA.
authors.forename: Wassim
authors.initials: W
authors.lastname: Chemaitilly
authors.affiliation: Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, USA; Department of Oncology, St Jude Children's Research Hospital, Memphis, USA.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Mulrooney
authors.affiliation: Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, USA; Department of Psychology, St Jude Children's Research Hospital, Memphis, USA.
authors.forename: Tara M
authors.initials: TM
authors.lastname: Brinkman
authors.affiliation: Department of Biostatistics, St Jude Children's Research Hospital, Memphis, USA.
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, USA.
authors.forename: Pia
authors.initials: P
authors.lastname: Banerjee
authors.affiliation: Department of Biostatistics, St Jude Children's Research Hospital, Memphis, USA.
authors.forename: Deokumar
authors.initials: D
authors.lastname: Srivastava
authors.affiliation: Department of Oncology, St Jude Children's Research Hospital, Memphis, USA.
authors.forename: Ching-Hon
authors.initials: CH
authors.lastname: Pui
authors.affiliation: Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, USA.
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.affiliation: Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, USA; Department of Oncology, St Jude Children's Research Hospital, Memphis, USA.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Hudson
authors.affiliation: Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, USA; Department of Psychology, St Jude Children's Research Hospital, Memphis, USA. Electronic address: kevin.krull@stjude.org.
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Krull
mesh_terms: D000293:Adolescent; D000309:Adrenal Insufficiency / Q000097:blood* / Q000209:etiology; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001288:Attention / Q000502:physiology*; D002648:Child; D060825:Cognitive Dysfunction / Q000209:etiology / Q000503:physiopathology*; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy*; D012737:Sex Factors; D017741:Survivors; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D019314:Dehydroepiandrosterone Sulfate
keywords: Attention; Chemotherapy; Childhood acute lymphoblastic leukemia; Dehydroepiandrosterone sulphate; Neurocognitive function