Oxidative Stress, Motor Abilities, and Behavioral Adjustment in Children Treated for Acute Lymphoblastic Leukemia
Marilyn J Hockenberry1, Kevin R Krull2, Kathleen C Insel3
1Duke University in Durham, NC.
Insights
Children undergoing chemotherapy for acute lymphoblastic leukemia (ALL) experience impaired fine motor and visual skills, linked to oxidative stress. Early interventions may help prevent lasting deficits and behavioral issues.
Area of Science:
- Pediatric Oncology
- Neuroscience
- Biochemistry
Background:
- Chemotherapy for acute lymphoblastic leukemia (ALL) can impact neurodevelopmental outcomes.
- Oxidative stress is implicated in various disease processes and may affect cognitive and motor functions.
Purpose of the Study:
- To investigate the relationship between oxidative stress, fine and visual-motor abilities, and behavioral adjustment in children with ALL undergoing chemotherapy.
- To assess changes in these abilities and behaviors throughout the course of treatment.
Main Methods:
- A prospective, repeated-measures design was employed with 89 children diagnosed with ALL.
- Cerebrospinal fluid samples were analyzed for oxidative stress biomarkers.
- Fine motor dexterity, visual processing speed, and visual-motor integration were assessed at multiple time points, alongside parent-reported behavioral ratings.
Main Results:
- Children with ALL exhibited below-average fine motor dexterity and visual-motor integration post-induction therapy, with deficits persisting by the end of treatment.
- Visual processing speed normalized by the end of therapy.
- Oxidative stress biomarkers correlated with impaired fine motor dexterity and visual-motor integration, and reduced motor function was associated with increased hyperactivity and anxiety.
Conclusions:
- Chemotherapy for childhood ALL is associated with increased oxidative stress, which correlates with deficits in fine motor skills and visual-motor integration.
- These motor and visual impairments may contribute to behavioral issues such as hyperactivity and anxiety.
- Early interventions are recommended to mitigate potential long-term fine motor, visual-spatial, and behavioral problems in pediatric ALL survivors.
Purpose/Objectives:
To examine associations among oxidative stress, fine and visual-motor abilities, and behavioral adjustment in children receiving chemotherapy for acute lymphoblastic leukemia (ALL) .
Design:
A prospective, repeated-measures design .
Setting:
Two pediatric oncology settings in the southwestern United States.
Sample:
89 children with ALL were followed from diagnosis to the end of chemotherapy.
Methods:
Serial cerebrospinal fluid samples were collected during scheduled lumbar punctures and analyzed for oxidative stress biomarkers. Children completed fine motor dexterity, visual processing speed, and visual-motor integration measures at three time points. Parents completed child behavior ratings at the same times.
Main Research Variables:
Oxidative stress, fine motor dexterity, visual processing, visual-motor integration, and behavioral adjustment .
Findings:
Children with ALL had below-average fine motor dexterity, visual processing speed, and visual-motor integration following the induction phase of ALL therapy. By end of therapy, visual processing speed normalized, and fine motor dexterity and visual-motor integration remained below average. Oxidative stress measures correlated with fine motor dexterity and visual-motor integration. Decreased motor functioning was associated with increased hyperactivity and anxiety .
Conclusions:
Oxidative stress occurs following chemo-therapy for childhood ALL and is related to impaired fine motor skills and visual symptoms .
Implications For Nursing:
Early intervention should be considered to prevent fine motor and visual-spatial deficits, as well as behavioral problems.
