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Neurodevelopmental sequelae of pediatric acute lymphoblastic leukemia and its treatment
Laura A Janzen1, Brenda J Spiegler
1Department of Psychology, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada. laura.janzen@sickkids.ca
Insights
Most children with standard-risk acute lymphoblastic leukemia (ALL) have good neurocognitive outcomes after chemotherapy. However, some subgroups face significant challenges, highlighting the need to address long-term cognitive health.
Area of Science:
- Pediatric Oncology
- Neuropsychology
- Hematology
Background:
- Pediatric acute lymphoblastic leukemia (ALL) treatment has improved survival rates.
- Long-term neurocognitive outcomes are critical for quality of life in survivors.
- Understanding treatment-related cognitive effects is essential for comprehensive care.
Purpose of the Study:
- To review neurocognitive outcomes in pediatric acute lymphoblastic leukemia (ALL).
- To identify factors influencing cognitive function post-treatment.
- To guide future research and clinical interventions.
Main Methods:
- Comprehensive literature review.
- Analysis of methodological issues in existing studies.
- Examination of treatment protocols, risk factors, and special populations.
Main Results:
- Majority of standard-risk pediatric ALL patients show good neurocognitive outcomes.
- Specific subgroups experience significant neurocognitive deficits.
- Neuroimaging findings correlate with cognitive status.
Conclusions:
- While many pediatric ALL survivors fare well cognitively, vulnerable subgroups require targeted support.
- Improving neurocognitive outcomes is a key challenge in pediatric ALL survivorship.
- Future research should focus on prevention and amelioration of neuropsychological sequelae.
Abstract:
This review will describe the neurocognitive outcomes associated with pediatric acute lymphoblastic leukemia (ALL) and its treatment. The literature is reviewed with the aim of addressing methodological issues, treatment factors, risks and moderators, special populations, relationship to neuroimaging findings, and directions for future research. It is concluded that neurocognitive outcomes for the majority of children with standard-risk ALL treated according to current chemotherapy protocols is relatively good, but subgroups of children are more significantly compromised. As medical treatments advance and survival rates continue to improve, neurocognitive outcomes and other quality of life indicators will become increasingly important. Preventing or ameliorating treatment-related neuropsychological sequelae represents the next major challenge in pediatric ALL.
