Chemotherapeutic CNS prophylaxis and neuropsychologic change in children with acute lymphoblastic leukemia: A prospective study

Kimberly Andrews Espy, Ida M. Moore, Paul M. Kaufmann, Joel H. Kramer, Katherine Matthay, John J. Hutter

Research output: Contribution to journalArticle

93 Scopus citations

Abstract

Objective: To determine whether prophylactic CNS chemotherapy for childhood acute lymphoblastic leukemia is associated with declines in neuropsychological abilities. Methods: Growth curve analysis was used to examine neuropsychological outcome and treatment-related change in children (N = 30) who were treated at two childhood cancer centers. A comprehensive test battery was administered at baseline (8 months), 2, 3, and 4 years postdiagnosis (age at diagnosis M = 5.90 years, SD = 4.20). Results: Results indicated modest declines in arithmetic, visual motor integration, and verbal fluency. Intrathecal and systemic treatment was related to poorer visual motor integration at 4 years postdiagnosis and a faster rate of decline in visual motor integration skills across the observation period than intrathecal treatment alone. Arithmetic proficiency at 4 years after diagnosis was related to maternal education, but the rate of decline was not. Verbal fluency was unrelated to demographic or treatment variables. Conclusions: These findings suggest that neuropsychological outcome and declines are related to both demographic and treatment characteristics depending on the cognitive domain examined.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalJournal of pediatric psychology
Volume26
Issue number1
DOIs
StatePublished - Feb 6 2001

Keywords

  • CNS late effects
  • Childhood cancer
  • Growth curve analysis
  • Neuropsychology

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology

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