Language-related skills in children with acute lymphocytic leukemia

The success of cranial irradiation and chemotherapy in the treatment of acute lymphocytic leukemia (ALL) has raised concerns about possible central nervous system damage in long-term survivors. The current study focused on language-related skill measures obtained as part of a neuropsychological test battery. Performance was analyzed as a function of age at diagnosis and age at evaluation in a sample of 110 children with ALL (mean age = 13.28 years). Results, although for the most part nonsignificant, do reveal significantly poorer performance on an Aphasia Screening Test rating by those diagnosed early (at or before five years of age) and assessed at or before 13 years of age when contrasted with those diagnosed early and assessed after their thirteenth year. Further analysis revealed a significant decline in spelling scores for those off therapy for more than two years. There was also a consistent trend for decline across most language-related skills measures as time off therapy increased. These results reflect either recovery from mild acute language dysfunction over time superimposed on a general trend for decline in language-related skills as time off therapy increases, or sampling error. Suggestions for future lines of investigation are discussed.