Journal of Pediatric Psychology, Vol. 26, No. 1, 2001, pp. 1-9
© 2001 Society of Pediatric Psychology
Chemotherapeutic CNS Prophylaxis and Neuropsychologic Change in Children With Acute Lymphoblastic Leukemia: A Prospective Study
1 Southern Illinois University, 2 University of Arizona, 3 Clyde L. Choate Mental Health and Developmental Center, 4 University of California-San Francisco
All correspondence should be sent to Kimberly Andrews Espy, Department of Psychiatry, Mail Stop 6503, Southern Illinois University School of Medicine, Carbondale, Illinois 62901-6503. E-mail: kespy{at}siumed.edu .
Objective: To determine whether prophylactic CNS chemotherapy for childhood acute lymphoblastic leukemia is associated with declines in neuropsychological abilities.
Methods: Growth curve analysis was used to examine neuropsychological outcome and treatment-related change in children (N = 30) who were treated at two childhood cancer centers. A comprehensive test battery was administered at baseline (8 months), 2, 3, and 4 years postdiagnosis (age at diagnosis M = 5.90 years, SD = 4.2C).
Results: Results indicated modest declines in arithmetic, visual motor integration, and verbal fluency. Intrathecal and systemic treatment was related to poorer visual motor integration at 4 years postdiagnosis and a faster rate of decline in visual motor integration skills across the observation period than intrathecal treatment alone. Arithmetic proficiency at 4 years after diagnosis was related to maternal education, but the rate of decline was not. Verbal fluency was unrelated to demographic or treatment variables.
Conclusions: These findings suggest that neuropsychological outcome and declines are related to both demographic and treatment characteristics depending on the cognitive domain examined.
Key words: childhood cancer; CNS late effects; neuropsychology; growth curve analysis.
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