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Association between fatigue and sleep disturbances during treatment for pediatric acute lymphoblastic leukemia and

Priscilla Vasquez1, Johanna Escalante2, Kimberly P Raghubar2

  • 1Department of Pediatrics, Section of Oncology, Baylor College of Medicine, Houston, Texas, USA.

Pediatric Blood & Cancer
|December 10, 2021
PubMed

Insights

High fatigue and sleep disturbances during acute lymphoblastic leukemia (ALL) treatment in children are linked to poorer long-term neurocognitive outcomes, particularly attention deficits.

Area of Science:

  • Pediatric Oncology
  • Neuroscience
  • Sleep Medicine

Background:

  • Survivors of pediatric acute lymphoblastic leukemia (ALL) face increased risks of neurocognitive deficits, including issues with attention, executive function, and processing speed.
  • While fatigue and sleep disturbances are common during ALL treatment and affect cognition, their long-term impact on neurocognitive performance post-treatment is not well understood.

Purpose of the Study:

  • To investigate the relationship between fatigue and sleep profiles during active pediatric acute lymphoblastic leukemia (ALL) treatment and subsequent neurocognitive performance.
  • To identify distinct subgroups of patients based on their fatigue and sleep patterns during therapy.

Main Methods:

  • A cohort of 120 pediatric patients with ALL completed fatigue and sleep questionnaires at four time points during treatment.
  • Latent class growth analysis identified patient subgroups with similar fatigue and sleep trajectories.
  • Neurocognitive performance was assessed in 40 participants more than six months after treatment completion and compared between identified subgroups.

Main Results:

  • Two distinct fatigue and sleep profiles were identified: Class 1 (mild disturbances) and Class 2 (higher disturbances), representing 50.8% and 49.2% of patients, respectively.
  • Most post-treatment cognitive measures were within the normal range, but attention, executive function, and verbal short-term memory were below normative means.
  • Patients in Class 2 exhibited significantly poorer neurocognitive performance compared to Class 1, especially in attention-related tasks.

Conclusions:

  • Fatigue and sleep disturbances experienced during the initial year of pediatric ALL therapy may negatively influence long-term neurocognitive functioning.
  • Targeting interventions for sleep and fatigue during treatment could be crucial for preserving cognitive abilities in pediatric ALL survivors.
Abstract

Keywords:
attentionexecutive functionfatiguememoryneurocognitivepediatric acute lymphoblastic leukemiasleep

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