Document Detail


Neuropsychological outcomes of standard risk and high risk patients treated for acute lymphoblastic leukemia on Dana-Farber ALL consortium protocol 95-01 at 5 years post-diagnosis.
MedLine Citation:
PMID:  21721112     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Children treated for acute lymphoblastic leukemia (ALL) as High Risk (HR) patients may be more vulnerable to neurocognitive late effects because of the greater intensity of their therapy. We compared neuropsychological outcomes in children treated for Standard Risk (SR) or HR ALL on Dana-Farber Cancer Institute (DFCI) Consortium ALL Protocol 95-01. We also evaluated their performance relative to normative expectations.
PROCEDURE: Between 1996 and 2000, 498 children with newly diagnosed ALL were treated on Protocol 95-01, 298 of whom were eligible for neuropsychological follow-up. A feature of this protocol was modification of risk group criteria to treat more children as SR rather than HR patients, intended to minimize toxicities. Testing was completed at a median of 5.3 years post-diagnosis for 211 patients (70.8%; ages 6-25 years; 45.5% male; 40% HR), all of whom were in continuous complete remission.
RESULTS: Test scores for both groups were generally at or above normative expectation, with the exception of verbal working memory, processing complex visual information, and parent ratings of metacognitive skills. After adjusting for covariates, the SR group performed better on measures of IQ and academic achievement, working memory and visual learning. Effect sizes, however, were only in the small to moderate range.
CONCLUSIONS: HR patients exhibited neuropsychological deficits relative to SR patients, though the differences were modest in degree. Modification of the risk group criteria to treat more children on the SR protocol therefore likely afforded some benefit in terms of neurocognitive late effects.
Authors:
Deborah P Waber; Jennifer Turek Queally; Lori Catania; Philippe Robaey; Ivonne Romero; Heather Adams; Cheryl Alyman; Christine Jandet-Brunet; Stephen E Sallan; Lewis B Silverman
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-06-30
Journal Detail:
Title:  Pediatric blood & cancer     Volume:  58     ISSN:  1545-5017     ISO Abbreviation:  Pediatr Blood Cancer     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-03-05     Completed Date:  2012-04-23     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  101186624     Medline TA:  Pediatr Blood Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  758-65     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Wiley Periodicals, Inc.
Affiliation:
Division of Psychology, Department of Psychiatry, Children's Hospital Boston, Boston, Massachusetts 02115, USA. deborah.waber@childrens.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Child, Preschool
Cognition*
Female
Humans
Infant
Male
Neuropsychological Tests
Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*,  psychology
Regression Analysis
Risk
Grant Support
ID/Acronym/Agency:
2 P01 CA 68484/CA/NCI NIH HHS; P01 CA068484/CA/NCI NIH HHS; P01 CA068484-10/CA/NCI NIH HHS; P30-HD18655/HD/NICHD NIH HHS; UL1 RR024160/RR/NCRR NIH HHS
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