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Acute lymphoblastic leukemia: long-term psychological outcome
R K Mulhern1, A G Friedman, P A Stone
1Division of Psychology, St. Jude Children's Research Hospital, Memphis, TN.
Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie
|January 1, 1988
Summary
Long-term survivors of childhood acute lymphoblastic leukemia (ALL) face significant risks of neuropsychological and psychosocial challenges. Early identification of these issues is crucial for effective intervention and improved outcomes for young cancer survivors.
Area of Science:
- Pediatric Oncology
- Neuropsychology
- Child Psychology
Background:
- Childhood acute lymphoblastic leukemia (ALL) treatment has improved survival rates significantly.
- Concerns are rising regarding the long-term psychological and neuropsychological effects on ALL survivors.
- This review focuses on the adjustment of survivors after completing ALL treatment.
Purpose of the Study:
- To review the literature on neuropsychological and psychosocial adjustment in long-term childhood ALL survivors.
- To identify risk factors associated with adverse outcomes in ALL survivors.
- To highlight the importance of early problem detection and intervention.
Main Methods:
- Selective literature review of studies on childhood ALL survivors.
- Analysis of data concerning neuropsychological deficits and psychosocial adjustment.
- Examination of factors influencing school-related problems.
Main Results:
- Conflicting findings exist regarding neuropsychological deficiencies in children in continuous remission.
- Survivors of central nervous system (CNS) relapse have a clearly elevated risk of neuropsychological deficits.
- Long-term childhood cancer survivors have a 30-40% risk of school-related problems, with cranial irradiation increasing this risk 3-4 fold.
Conclusions:
- Neuropsychological and psychosocial challenges are significant concerns for long-term ALL survivors.
- Cranial irradiation is a key risk factor for school-related difficulties.
- Early identification and intervention are essential to mitigate long-term difficulties for ALL survivors.