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Related Experiment Videos

Intelligence function in children with acute lymphoblastic leukemia after treatment

H Qin1, J Fu, Y Zhang

  • 1Beijing Children's Hospital.

Chinese Medical Sciences Journal = Chung-Kuo I Hsueh K'O Hsueh Tsa Chih
|June 1, 1993
PubMed
Summary

Chemotherapy and central nervous system prophylaxis in children with acute lymphoblastic leukemia (ALL) can negatively impact intelligence. Later treatment regimens showed some improvement, but IQ deficits persisted, correlating with radiation and MTX exposure.

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Area of Science:

  • Pediatric Oncology
  • Neuropsychology
  • Childhood Cancer Research

Background:

  • Acute lymphoblastic leukemia (ALL) is a common childhood cancer.
  • Treatment regimens, including chemotherapy and central nervous system (CNS) prophylaxis, may affect cognitive development.
  • Understanding the long-term neurocognitive effects of ALL treatment is crucial for patient care.

Purpose of the Study:

  • To evaluate the impact of different chemotherapy and CNS prophylaxis regimens on the intelligence function of children with ALL.
  • To compare cognitive outcomes between patients treated during different time periods and a healthy control group.
  • To identify specific treatment factors associated with intelligence deficits in pediatric ALL survivors.

Main Methods:

  • 147 children with ALL were divided into two groups based on treatment era (1981-1986 vs. 1988-1990).

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  • A control group of 73 healthy children with similar backgrounds was included for comparison.
  • Chinese revisions of Wechsler intelligence scales assessed verbal IQ, performance IQ, and total IQ; data analyzed using Systate software.

    • Main Results:

    • Patients in the earlier treatment group (Group A) exhibited significantly lower IQ scores (verbal, performance, and total) compared to controls.
    • Patients in the later treatment group (Group B) also showed reduced verbal and total IQ scores compared to controls.
    • Significant differences in verbal, performance, and total IQ were observed between Group A and Group B, indicating treatment improvements.
    • Multiple regression analysis revealed negative correlations between IQ and cranial irradiation dosage, intrathecal methotrexate (MTX) frequency, and time since irradiation.

    Conclusions:

    • Chemotherapy and CNS prophylaxis in pediatric ALL significantly impact intelligence function.
    • While later treatment protocols (Group B) showed some cognitive benefits over earlier ones (Group A), deficits remain.
    • Cranial irradiation and intrathecal MTX are key factors contributing to neurocognitive impairment in ALL survivors.