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Cognitive assessment of children with acute lymphoblastic leukemia: Preliminary findings
1Clinical Psychology Unit, Kidwai Memorial, Institute of Oncology (KMIO), Bangalore, Karnataka, India.
Insights
Cognitive functions in Indian children with acute lymphoblastic leukemia (ALL) declined significantly after treatment initiation, particularly in intelligence quotient and analytical reasoning. Early identification and management of these cognitive deficits are crucial for rehabilitation.
Area of Science:
- Pediatric Oncology
- Neuropsychology
- Childhood Cancer Research
Background:
- Limited prospective longitudinal research exists on the cognitive outcomes of Indian children undergoing treatment for acute lymphoblastic leukemia (ALL).
- Western studies often focus on ALL survivors, whereas this study examines cognitive function during and after initial treatment phases.
Purpose of the Study:
- To assess the cognitive functions of Indian children diagnosed with acute lymphoblastic leukemia (ALL) during and after the initiation of treatment.
- To provide longitudinal data on cognitive outcomes in a pediatric ALL population within India.
Main Methods:
- Cognitive functions of 19 pediatric patients with ALL were evaluated using standardized tests.
- Assessments were conducted after induction chemotherapy and periodically following subsequent treatment, including central nervous system-directed radiotherapy and intrathecal methotrexate.
Main Results:
- A statistically significant decline in overall intelligence quotient (IQ) was observed in the studied children.
- Deficits were specifically noted in the cognitive function of analytical reasoning.
Conclusions:
- This preliminary study corroborates previous Indian and Western research on cognitive impairments in children with ALL.
- Given increased survival rates, proactive identification and management of cognitive difficulties are essential for the comprehensive rehabilitation of pediatric ALL patients.
Aim:
The objective of this study was to assess the cognitive functions of Indian children with acute lymphoblastic leukemia (ALL), periodically after initiation of treatment since prospective longitudinal research in this area on the Indian population has not been adequately documented. Unlike many western studies that have targeted survivors of ALL, we aimed to bring out the cognitive outcome after initiation of treatment.
Materials And Methods:
The cognitive functions of 19 patients diagnosed to have ALL were assessed using standardized tests after induction chemotherapy, and periodically thereafter following the second course of treatment comprising central nervous system-directed radiotherapy, and chemotherapy using intrathecal methotrexate.
Results:
The study found a statistically significant decline in the intelligence quotient and a deficit in the cognitive function of analytical reasoning.
Conclusion:
This preliminary study supports findings of an earlier Indian study and many studies conducted in the west. Since the life expectancy of these children has increased and most of them have long-term survival, and even cure, we suggest that identifying and managing children with cognitive difficulties are important in the rehabilitation of these children.
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