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Neurocognitive deficits in survivors of childhood acute myeloid leukemia
Satoko Takahashi1,2, Satomi Sato3, Shunji Igarashi4
1Department of Pediatrics, Japanese Red Cross Narita Hospital, 90-1 Iida-cho, Narita-shi, Chiba, 286-8523, Japan. satoko_y0115@ga2.so-net.ne.jp.
Insights
Children treated for acute myeloid leukemia (AML) may experience working memory deficits, even with normal overall intelligence. Early identification and intervention are crucial for survivors' quality of life.
Area of Science:
- Pediatric Oncology
- Neuroscience
- Cognitive Psychology
Background:
- Acute myeloid leukemia (AML) treatments often involve neurotoxic agents.
- Neurocognitive outcomes in childhood AML survivors are understudied.
- Late cognitive effects of high-dose cytarabine regimens require investigation.
Purpose of the Study:
- To evaluate late cognitive effects in children treated for AML.
- To assess general intellectual ability and specific neurocognitive domains.
- To identify factors associated with cognitive outcomes.
Main Methods:
- Assessed 12 childhood AML survivors using Wechsler Intelligence Scales.
- Employed one-sample t-tests and one-way ANOVA for score comparisons.
- Utilized univariate and multiple regression analyses for demographic and clinical factors.
Main Results:
- Impairment in working memory was observed in participants.
- No significant differences in overall intelligence quotient (FSIQ) compared to norms.
- Time since diagnosis and age at assessment predicted FSIQ.
Conclusions:
- Childhood AML survivors can have working memory impairments despite normal FSIQ.
- Cognitive deficits impact quality of life.
- Targeted interventions are needed for at-risk survivors.
Background:
Although treatment of acute myeloid leukemia (AML) contains neurotoxic agents, studies investigating neurocognitive outcomes in children with AML are sparse. We evaluated late cognitive effects in children treated with a high-dose cytarabine based regimen, focusing on general intellectual ability and specific neurocognitive domains.
Methods:
We evaluated 12 survivors of childhood AML who were treated between 2006 and 2016 and completed the Wechsler Intelligence Scales. One-sample t-tests were used to compare full-scale intelligence quotient (FSIQ) and primary index scores to norms. The overall effect of index scores and subtests was examined with one-way ANOVA. Univariate analyses and multiple regression models examined demographic and clinical characteristics associated with FSIQ.
Results:
Participants who underwent the Wechsler Intelligence Scale for Children demonstrated impairment on working memory index and participants who underwent the Wechsler Adult Intelligence Scale showed low score in the subtests that reflect working memory, whereas they exhibited no statistical differences versus the population means for FSIQ. There were no significant differences in the overall effect of index scores and subtests. On univariate analysis, FSIQ were related to time since diagnosis and age at assessment, and both were significant predictors of FSIQ on multiple linear regression.
Conclusions:
Survivors of childhood AML exhibited impairment of working memory, even if their FSIQ was within the normal range. Difficulties in specific cognitive domains are associated with reduced quality of life. It is important to identify survivors who are at risk and provide tailored interventions.
