Abstract
Background: Previous research has indicated that children who have received treatment for leukaemia which includes cranial irradiation exhibit deficits in their ability to focus attention. It has been suggested that the use of cranial irradiation may have a role to play in long term sequelae.
Aims: To investigate neuropsychological functioning among children treated for leukaemia without cranial irradiation.
Methods: In a cross sectional study, 17 leukaemic patients and their sibling controls were assessed using a neuropsychological model of attention. All were treated on the UKALL XI protocol and none had received cranial irradiation. Participants completed the Arithmetic subtest and Digit Span subtest of the Weschler Intelligence Scale for Children–Revised to assess focus–encode elements of attention; the Coding subtest and the Speed of Information subtest of the BAS to assess focus–execute aspects of attention; the VIGIL computerised battery to assess sustain elements of attention; and the Wisconsin Card Sorting test to assess the ability to shift attention.
Results: These children did not exhibit the deficits witnessed in previous cohorts, and were performing at comparable levels to their controls on all measures of attention
Conclusions: These findings suggest that children who have received treatment for leukaemia without the use of cranial irradiation do not show the neuropsychological insult found in earlier treatment groups.
Full Text
The Full Text of this article is available as a PDF (83.6 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- BECK L. H., BRANSOME E. D., Jr, MIRSKY A. F., ROSVOLD H. E., SARASON I. A continuous performance test of brain damage. J Consult Psychol. 1956 Oct;20(5):343–350. doi: 10.1037/h0043220. [DOI] [PubMed] [Google Scholar]
- Brouwers P., Poplack D. Memory and learning sequelae in long-term survivors of acute lymphoblastic leukemia: association with attention deficits. Am J Pediatr Hematol Oncol. 1990 Summer;12(2):174–181. doi: 10.1097/00043426-199022000-00009. [DOI] [PubMed] [Google Scholar]
- Brown R. T., Sawyer M. G., Antoniou G., Toogood I., Rice M. Longitudinal follow-up of the intellectual and academic functioning of children receiving central nervous system-prophylactic chemotherapy for leukemia: a four-year final report. J Dev Behav Pediatr. 1999 Oct;20(5):373–377. doi: 10.1097/00004703-199910000-00013. [DOI] [PubMed] [Google Scholar]
- Chessells J. M., Harrison G., Richards S. M., Bailey C. C., Hill F. G., Gibson B. E., Hann I. M. Down's syndrome and acute lymphoblastic leukaemia: clinical features and response to treatment. Arch Dis Child. 2001 Oct;85(4):321–325. doi: 10.1136/adc.85.4.321. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Coles C. D., Platzman K. A., Raskind-Hood C. L., Brown R. T., Falek A., Smith I. E. A comparison of children affected by prenatal alcohol exposure and attention deficit, hyperactivity disorder. Alcohol Clin Exp Res. 1997 Feb;21(1):150–161. [PubMed] [Google Scholar]
- Eiser C., Lansdown R. Retrospective study of intellectual development in children treated for acute lymphoblastic leukaemia. Arch Dis Child. 1977 Jul;52(7):525–529. doi: 10.1136/adc.52.7.525. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Goff J. R., Anderson H. R., Jr, Cooper P. F. Distractibility and memory deficits in long-term survivors of acute lymphoblastic leukemia. J Dev Behav Pediatr. 1980 Dec;1(4):158–163. [PubMed] [Google Scholar]
- Harila-Saari A. H., Vainionpä L. K., Kovala T. T., Tolonen E. U., Lanning B. M. Nerve lesions after therapy for childhood acute lymphoblastic leukemia. Cancer. 1998 Jan 1;82(1):200–207. doi: 10.1002/(sici)1097-0142(19980101)82:1<200::aid-cncr25>3.0.co;2-5. [DOI] [PubMed] [Google Scholar]
- Hill J. M., Kornblith A. B., Jones D., Freeman A., Holland J. F., Glicksman A. S., Boyett J. M., Lenherr B., Brecher M. L., Dubowy R. A comparative study of the long term psychosocial functioning of childhood acute lymphoblastic leukemia survivors treated by intrathecal methotrexate with or without cranial radiation. Cancer. 1998 Jan 1;82(1):208–218. [PubMed] [Google Scholar]
- Kingma A., Rammeloo L. A., van Der Does-van den Berg A., Rekers-Mombarg L., Postma A. Academic career after treatment for acute lymphoblastic leukaemia. Arch Dis Child. 2000 May;82(5):353–357. doi: 10.1136/adc.82.5.353. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kremen W. S., Seidman L. J., Faraone S. V., Pepple J. R., Tsuang M. T. Attention/information-processing factors in psychotic disorders. Replication and extension of recent neuropsychological findings. J Nerv Ment Dis. 1992 Feb;180(2):89–93. doi: 10.1097/00005053-199202000-00004. [DOI] [PubMed] [Google Scholar]
- Massenkeil G., Späth-Schwalbe E., Flath B., Gottschalk S., Lehmann R., Arnold R. Transient tetraparesis after intrathecal and high-dose systemic methotrexate. Ann Hematol. 1998 Nov;77(5):239–242. doi: 10.1007/s002770050450. [DOI] [PubMed] [Google Scholar]
- Mirsky A. F., Anthony B. J., Duncan C. C., Ahearn M. B., Kellam S. G. Analysis of the elements of attention: a neuropsychological approach. Neuropsychol Rev. 1991 Jun;2(2):109–145. doi: 10.1007/BF01109051. [DOI] [PubMed] [Google Scholar]
- Ozonoff S., Rogers S. J., Pennington B. F. Asperger's syndrome: evidence of an empirical distinction from high-functioning autism. J Child Psychol Psychiatry. 1991 Nov;32(7):1107–1122. doi: 10.1111/j.1469-7610.1991.tb00352.x. [DOI] [PubMed] [Google Scholar]
- Pogge D. L., Stokes J. M., Harvey P. D. Empirical evaluation of the factorial structure of attention in adolescent psychiatric patients. J Clin Exp Neuropsychol. 1994 Jun;16(3):344–353. doi: 10.1080/01688639408402645. [DOI] [PubMed] [Google Scholar]
- Rodgers J., Britton P. G., Kernahan J., Craft A. W. Cognitive function after two doses of cranial irradiation for acute lymphoblastic leukaemia. Arch Dis Child. 1991 Oct;66(10):1245–1246. doi: 10.1136/adc.66.10.1245. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rodgers J., Horrocks J., Britton P. G., Kernahan J. Attentional ability among survivors of leukaemia. Arch Dis Child. 1999 Apr;80(4):318–323. doi: 10.1136/adc.80.4.318. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Said J. A., Waters B. G., Cousens P., Stevens M. M. Neuropsychological sequelae of central nervous system prophylaxis in survivors of childhood acute lymphoblastic leukemia. J Consult Clin Psychol. 1989 Apr;57(2):251–256. doi: 10.1037//0022-006x.57.2.251. [DOI] [PubMed] [Google Scholar]
- Schatz J., Kramer J. H., Ablin A., Matthay K. K. Processing speed, working memory, and IQ: a developmental model of cognitive deficits following cranial radiation therapy. Neuropsychology. 2000 Apr;14(2):189–200. doi: 10.1037//0894-4105.14.2.189. [DOI] [PubMed] [Google Scholar]
- Twaddle V., Britton P. G., Kernahan J., Craft A. W. Intellect after malignancy. Arch Dis Child. 1986 Jul;61(7):700–702. doi: 10.1136/adc.61.7.700. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ueberall M. A., Skirl G., Strassburg H. M., Wenzel D., Hertzberg H., Langer T., Meier W., Berger-Jones K., Huk W. J., Korinthenberg R. Neurophysiological findings in long-term survivors of acute lymphoblastic leukaemia in childhood treated with the BFM protocol 81 SR-A/B. Eur J Pediatr. 1997 Sep;156(9):727–733. doi: 10.1007/s004310050700. [DOI] [PubMed] [Google Scholar]
- Waber D. P., Carpentieri S. C., Klar N., Silverman L. B., Schwenn M., Hurwitz C. A., Mullenix P. J., Tarbell N. J., Sallan S. E. Cognitive sequelae in children treated for acute lymphoblastic leukemia with dexamethasone or prednisone. J Pediatr Hematol Oncol. 2000 May-Jun;22(3):206–213. doi: 10.1097/00043426-200005000-00004. [DOI] [PubMed] [Google Scholar]
- Whitt J. K., Wells R. J., Lauria M. M., Wilhelm C. L., McMillan C. W. Cranial radiation in childhood acute lymphocytic leukemia. Neuropsychologic sequelae. Am J Dis Child. 1984 Aug;138(8):730–736. doi: 10.1001/archpedi.1984.02140460022009. [DOI] [PubMed] [Google Scholar]
- von der Weid N., Swiss Pediatric Oncology Group (SPOG) Late effects in long-term survivors of ALL in childhood: experiences from the SPOG late effects study. Swiss Med Wkly. 2001 Apr 7;131(13-14):180–187. doi: 10.4414/smw.2001.09671. [DOI] [PubMed] [Google Scholar]
