Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Cranial Radiation in Childhood Acute Lymphocytic Leukemia: Neuropsychologic Sequelae

Cranial Radiation in Childhood Acute Lymphocytic Leukemia: Neuropsychologic Sequelae Abstract • A battery of neuropsychologic tests was administered "blindly" to 18 children with acute lymphocytic leukemia (ALL) who had been randomly assigned to treatment regimens with or without cranial radiation. These children were all in complete continuous remission for more than 3½ years and were no longer receiving therapy. The results indicated no substantial differences between groups as a function of radiation therapy. However, decreased neuropsychologic performance was found when the entire sample was compared with population norms. These data do not support the hypothesis that cranial radiation therapy is responsible for the neuropsychologic sequelae seen in these survivors of ALL. Post hoc multiple regression analysis indicated that parental education levels accounted for more of the neuropsychologic variability seen in these children than other factors such as age at diagnosis, type of therapy, or sex of child. (AJDC 1984;138:730-736) References 1. Mauer AM: Therapy of acute lymphocytic leukemia in childhood . Blood 1980;56:1-10. 2. Pinkel D: Treatment of acute lymphocytic leukemia . Cancer 1979;43:1128-1137.Crossref 3. Sallan SE, Weinstein HJ, Nathan DG: The childhood leukemias . J Pediatr 1981;99:676-688.Crossref 4. Soni SS, Marten GW, Pitner SE, et al: Effects of central nervous system irradiation on neuropsychologic functioning of children with acute lymphocytic leukemia . N Engl J Med 1975;293:113-118.Crossref 5. Verzosa MS, Aur RJA, Simone JV, et al: Five years after central nervous system irradiation of children with leukemia . Int J Radiat Oncol Biol Phys 1976;1:209-215.Crossref 6. Obetz SW, Smithson WA, Groover RV, et al: Neuropsychologic follow-up study of children with acute lymphocytic leukemia: A preliminary report . Am J Pediatr Hematol Oncol 1979;1: 207-213.Crossref 7. Meadows AT, Evans AE: Effects of chemotherapy on the central nervous system . Cancer 1976;37:1079-1085.Crossref 8. Eiser C: Intellectual abilities among survivors of childhood leukemia as a function of CNS irradiation . Arch Dis Child 1978;53:391-395.Crossref 9. Eiser C, Landsdown R: Retrospective study of intellectual development in children treated for ALL . Arch Dis Child 1977;52:525-529.Crossref 10. Goff JR, Anderson HR, Cooper PF: Distractibility and memory deficits in long-term survivors of acute lymphoblastic leukemia . Dev Behav Pediatr 1980;1:158-163.Crossref 11. Meadows AT, Gordon J, Littman P, et al: Patterns of cognitive dysfunctions in children with acute lymphocytic leukemia (ALL) treated with cranial radiation . Proc Am Assoc Cancer Res—Am Soc Clin Oncol 1980;21:386. 12. Stehbens JA, Ford ME, Kisker CT, et al: WISC-R Verbal/Performance discrepancies in pediatric cancer patients . J Pediatr Psychol 1981;6:61-68.Crossref 13. Wechsler D: Manual for the Wechsler Intelligence Scale for Children—Revised . New York, Psychological Corporation, 1974. 14. Beery KE, Buktenica NA: Developmental Test of Visual-Motor Integration . Chicago, Follett Publishing Co Inc, 1967. 15. Kagan J, Rosman BL, Day D, et al: Information processing in the child: Significance of analytic and reflective attitudes . Psychol Monogr 1964;78:1-37.Crossref 16. Kagan J, Messer SB: A reply to 'Some misgivings about the Matching Familiar Figures test as a measure of reflection-impulsivity.' Dev Psychol 1975;11:244-248.Crossref 17. Salkind N: The Development of Norms for the Matching Familiar Figures Test . Lawrence, Kan, University of Kansas, 1978. 18. Reitan RM, Davison LA: Clinical Neuropsychology: Current Status and Applications . New York, John Wiley & Sons Inc, 1974. 19. Jastak JF, Jastak SR: The Wide Range Achievement Test . Wilmington, Del, Jastak Associates, 1978. 20. Lorion RP: The evaluation of school adjustment , in Grave GD, Pless IB (eds): Chronic Childhood Illness: Assessment of Outcome . US Dept of Health, Education, and Welfare publication (NIH) 76-877. Bethesda, Md, US Dept of Health, Education, and Welfare, National Institutes of Health, 1974. 21. Spreen O, Gaddes WH: Developmental norms for 15 neuropsychological tests age 6 to 15 . Cortex 1969;5:171-191.Crossref 22. Knights RM: Smoothed Normative Data on Tests for Evaluating Brain Damage in Children . Ottawa, Carlton University, 1970. 23. Keppel G: Design and Analysis: A Researcher's Handbook . Englewood Cliffs, NJ, Prentice-Hall Inc, 1982. 24. Dunn OJ: Multiple comparisons among means . J Am Stat Assoc 1961;56:52-64.Crossref 25. Ivnik RJ, Colligan RC, Obetz SW, et al: Neuropsychologic performance among children in remission from acute lymphocytic leukemia . Dev Behav Pediatr 1981;2:29-34.Crossref 26. Moss HA, Nannis ED, Poplack DG: The effects of prophylactic treatment of the central nervous system on the intellectual functioning of children with acute lymphocytic leukemia . Am J Med 1981;71:47-52.Crossref 27. Meadows AT, Gordon J, Massari DJ, et al: Declines in IQ scores and cognitive dysfunctions in children with acute lymphocytic leukemia treated with cranial irradiation . Lancet 1981;2: 1015-1018.Crossref 28. Inati A, Sallan SE, Cassady JR, et al: Efficacy and morbidity of central nervous system 'prophylaxis' in childhood acute lymphoblastic leukemia: Eight years' experience with cranial irradiation and intrathecal methotrexate . Blood 1983;61:297-303. 29. Stehbens JA, Kisker CT, Wilson BK: Achievement and intelligence test-retest performance in pediatric cancer patients at diagnosis and one year later . J Pediatr Psychol 1983;8: 47-56.Crossref 30. Pavlovsky S, Fisman N, Arizaga R, et al: Neuropsychological study in patients with ALL . Am J Pediatr Hematol Oncol 1983;5:79-86. 31. Tamaroff M, Miller DR, Murphy ML, et al: Immediate and long-term posttherapy neuropsychologic performance in children with acute lymphoblastic leukemia treated without central nervous system radiation . J Pediatr 1982;101:524-529.Crossref 32. Kaufman AS: Factor analysis of the WISC-R at 11 age levels between 6½ and 16½ years . J Consult Clin Psychol 1975;43:135-147.Crossref 33. Haskins R, McKinney JD: Relative effects of response tempo and accuracy on problem solving and academic achievement . Child Dev 1976;47:690-696.Crossref 34. Robison L, Nesbit M, Sather H, et al: Intellectual function in long-term survivors of childhood acute lymphoblastic leukemia . Proc Am Soc Clin Oncol 1982;1:46. 35. Green DM, Freeman AI, Sather HN, et al: Comparison of three methods of central nervous system prophylaxis in childhood acute lymphocytic leukemia . Lancet 1980;1:1398-1401.Crossref 36. Sullivan MP, Chen T, Dyment PG, et al: Equivalence of intrathecal chemotherapy and radiotherapy as central nervous system prophylaxis in children with acute lymphatic leukemia: A pediatric oncology group study . Blood 1982;60: 948-958. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Cranial Radiation in Childhood Acute Lymphocytic Leukemia: Neuropsychologic Sequelae

Loading next page...
 
/lp/american-medical-association/cranial-radiation-in-childhood-acute-lymphocytic-leukemia-6OqykD4xrq

References (43)

Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1984.02140460022009
Publisher site
See Article on Publisher Site

Abstract

Abstract • A battery of neuropsychologic tests was administered "blindly" to 18 children with acute lymphocytic leukemia (ALL) who had been randomly assigned to treatment regimens with or without cranial radiation. These children were all in complete continuous remission for more than 3½ years and were no longer receiving therapy. The results indicated no substantial differences between groups as a function of radiation therapy. However, decreased neuropsychologic performance was found when the entire sample was compared with population norms. These data do not support the hypothesis that cranial radiation therapy is responsible for the neuropsychologic sequelae seen in these survivors of ALL. Post hoc multiple regression analysis indicated that parental education levels accounted for more of the neuropsychologic variability seen in these children than other factors such as age at diagnosis, type of therapy, or sex of child. (AJDC 1984;138:730-736) References 1. Mauer AM: Therapy of acute lymphocytic leukemia in childhood . Blood 1980;56:1-10. 2. Pinkel D: Treatment of acute lymphocytic leukemia . Cancer 1979;43:1128-1137.Crossref 3. Sallan SE, Weinstein HJ, Nathan DG: The childhood leukemias . J Pediatr 1981;99:676-688.Crossref 4. Soni SS, Marten GW, Pitner SE, et al: Effects of central nervous system irradiation on neuropsychologic functioning of children with acute lymphocytic leukemia . N Engl J Med 1975;293:113-118.Crossref 5. Verzosa MS, Aur RJA, Simone JV, et al: Five years after central nervous system irradiation of children with leukemia . Int J Radiat Oncol Biol Phys 1976;1:209-215.Crossref 6. Obetz SW, Smithson WA, Groover RV, et al: Neuropsychologic follow-up study of children with acute lymphocytic leukemia: A preliminary report . Am J Pediatr Hematol Oncol 1979;1: 207-213.Crossref 7. Meadows AT, Evans AE: Effects of chemotherapy on the central nervous system . Cancer 1976;37:1079-1085.Crossref 8. Eiser C: Intellectual abilities among survivors of childhood leukemia as a function of CNS irradiation . Arch Dis Child 1978;53:391-395.Crossref 9. Eiser C, Landsdown R: Retrospective study of intellectual development in children treated for ALL . Arch Dis Child 1977;52:525-529.Crossref 10. Goff JR, Anderson HR, Cooper PF: Distractibility and memory deficits in long-term survivors of acute lymphoblastic leukemia . Dev Behav Pediatr 1980;1:158-163.Crossref 11. Meadows AT, Gordon J, Littman P, et al: Patterns of cognitive dysfunctions in children with acute lymphocytic leukemia (ALL) treated with cranial radiation . Proc Am Assoc Cancer Res—Am Soc Clin Oncol 1980;21:386. 12. Stehbens JA, Ford ME, Kisker CT, et al: WISC-R Verbal/Performance discrepancies in pediatric cancer patients . J Pediatr Psychol 1981;6:61-68.Crossref 13. Wechsler D: Manual for the Wechsler Intelligence Scale for Children—Revised . New York, Psychological Corporation, 1974. 14. Beery KE, Buktenica NA: Developmental Test of Visual-Motor Integration . Chicago, Follett Publishing Co Inc, 1967. 15. Kagan J, Rosman BL, Day D, et al: Information processing in the child: Significance of analytic and reflective attitudes . Psychol Monogr 1964;78:1-37.Crossref 16. Kagan J, Messer SB: A reply to 'Some misgivings about the Matching Familiar Figures test as a measure of reflection-impulsivity.' Dev Psychol 1975;11:244-248.Crossref 17. Salkind N: The Development of Norms for the Matching Familiar Figures Test . Lawrence, Kan, University of Kansas, 1978. 18. Reitan RM, Davison LA: Clinical Neuropsychology: Current Status and Applications . New York, John Wiley & Sons Inc, 1974. 19. Jastak JF, Jastak SR: The Wide Range Achievement Test . Wilmington, Del, Jastak Associates, 1978. 20. Lorion RP: The evaluation of school adjustment , in Grave GD, Pless IB (eds): Chronic Childhood Illness: Assessment of Outcome . US Dept of Health, Education, and Welfare publication (NIH) 76-877. Bethesda, Md, US Dept of Health, Education, and Welfare, National Institutes of Health, 1974. 21. Spreen O, Gaddes WH: Developmental norms for 15 neuropsychological tests age 6 to 15 . Cortex 1969;5:171-191.Crossref 22. Knights RM: Smoothed Normative Data on Tests for Evaluating Brain Damage in Children . Ottawa, Carlton University, 1970. 23. Keppel G: Design and Analysis: A Researcher's Handbook . Englewood Cliffs, NJ, Prentice-Hall Inc, 1982. 24. Dunn OJ: Multiple comparisons among means . J Am Stat Assoc 1961;56:52-64.Crossref 25. Ivnik RJ, Colligan RC, Obetz SW, et al: Neuropsychologic performance among children in remission from acute lymphocytic leukemia . Dev Behav Pediatr 1981;2:29-34.Crossref 26. Moss HA, Nannis ED, Poplack DG: The effects of prophylactic treatment of the central nervous system on the intellectual functioning of children with acute lymphocytic leukemia . Am J Med 1981;71:47-52.Crossref 27. Meadows AT, Gordon J, Massari DJ, et al: Declines in IQ scores and cognitive dysfunctions in children with acute lymphocytic leukemia treated with cranial irradiation . Lancet 1981;2: 1015-1018.Crossref 28. Inati A, Sallan SE, Cassady JR, et al: Efficacy and morbidity of central nervous system 'prophylaxis' in childhood acute lymphoblastic leukemia: Eight years' experience with cranial irradiation and intrathecal methotrexate . Blood 1983;61:297-303. 29. Stehbens JA, Kisker CT, Wilson BK: Achievement and intelligence test-retest performance in pediatric cancer patients at diagnosis and one year later . J Pediatr Psychol 1983;8: 47-56.Crossref 30. Pavlovsky S, Fisman N, Arizaga R, et al: Neuropsychological study in patients with ALL . Am J Pediatr Hematol Oncol 1983;5:79-86. 31. Tamaroff M, Miller DR, Murphy ML, et al: Immediate and long-term posttherapy neuropsychologic performance in children with acute lymphoblastic leukemia treated without central nervous system radiation . J Pediatr 1982;101:524-529.Crossref 32. Kaufman AS: Factor analysis of the WISC-R at 11 age levels between 6½ and 16½ years . J Consult Clin Psychol 1975;43:135-147.Crossref 33. Haskins R, McKinney JD: Relative effects of response tempo and accuracy on problem solving and academic achievement . Child Dev 1976;47:690-696.Crossref 34. Robison L, Nesbit M, Sather H, et al: Intellectual function in long-term survivors of childhood acute lymphoblastic leukemia . Proc Am Soc Clin Oncol 1982;1:46. 35. Green DM, Freeman AI, Sather HN, et al: Comparison of three methods of central nervous system prophylaxis in childhood acute lymphocytic leukemia . Lancet 1980;1:1398-1401.Crossref 36. Sullivan MP, Chen T, Dyment PG, et al: Equivalence of intrathecal chemotherapy and radiotherapy as central nervous system prophylaxis in children with acute lymphatic leukemia: A pediatric oncology group study . Blood 1982;60: 948-958.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Aug 1, 1984

There are no references for this article.