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Cognitive, neuropsychological, and academic sequelae in children with leukemia
1Department of Pediatrics and Psychiatry, Emory University School of Medicine, Atlanta, GA 30322.
Insights
Children with leukemia experience cognitive and academic deficits due to cancer treatments like central nervous system (CNS) irradiation and intrathecal chemotherapy, often requiring special education services for school reentry.
Area of Science:
- Neuroscience
- Pediatric Oncology
- Developmental Psychology
Background:
- Children diagnosed with leukemia often face cognitive and neuropsychological deficits.
- These deficits are linked to treatments such as central nervous system (CNS) irradiation.
- Emerging evidence suggests intrathecal chemotherapy may also cause similar adverse effects.
Purpose of the Study:
- To review the cognitive and neuropsychological sequelae in children with leukemia.
- To highlight the impact of cancer treatments on academic achievement and school reentry.
- To underscore the need for specialized educational support for these children.
Main Methods:
- Literature review of studies on leukemia survivors.
- Analysis of cognitive, neuropsychological, and academic outcomes.
- Examination of treatment effects (CNS irradiation, intrathecal chemotherapy).
Main Results:
- Children with leukemia exhibit significant deficits in cognitive and neuropsychological functioning.
- Academic achievement is negatively impacted by iatrogenic effects of CNS irradiation and potentially intrathecal chemotherapy.
- Increased survival rates due to treatment advances necessitate addressing school reentry challenges.
Conclusions:
- Advances in leukemia treatment have improved life expectancy, leading to a focus on long-term sequelae.
- Neuropsychological and academic difficulties are common in childhood leukemia survivors.
- Many children with leukemia require special education services to facilitate successful school reentry and social adjustment.
Abstract:
The literature concerning the cognitive and neuropsychological sequelae of children in whom leukemia has been diagnosed indicates that these children exhibit deficits in cognitive and neuropsychological functioning and academic achievement in response to the iatrogenic effects of central nervous system (CNS) irradiation. Preliminary studies suggest that similar emanative effects may follow intrathecal chemotherapy, an alternative to CNS irradiation for children given a favorable prognosis. It is concluded that treatment advances have lengthened the life expectancy of many children with leukemia, thereby changing their prognosis to a more favorable one. This has resulted in a recognition of the difficulties accompanying school reentry. In light of their documented neuropsychological, academic, and social adjustment problems, many of these children require special education services.