Research Article

Progressive neurocognitive impairment in young adult survivors of childhood acute lymphoblastic leukemia

  1. Marika J. Harila MSc1,2,*,
  2. Satu Winqvist PhD2,
  3. Marjatta Lanning MD, PhD3,
  4. Risto Bloigu MSc4,
  5. Arja H. Harila-Saari MD, PhD3

Article first published online: 29 APR 2009

DOI: 10.1002/pbc.21992

Issue

Pediatric Blood & Cancer

Pediatric Blood & Cancer

Volume 53, Issue 2, pages 156–161, August 2009

Additional Information

How to Cite

Harila, M. J., Winqvist, S., Lanning, M., Bloigu, R. and Harila-Saari, A. H. (2009), Progressive neurocognitive impairment in young adult survivors of childhood acute lymphoblastic leukemia. Pediatric Blood & Cancer, 53: 156–161. doi: 10.1002/pbc.21992

Author Information

  1. 1

    Department of Medical Research, Oulu University Hospital, Oulu, Finland

  2. 2

    Department of Neurology, Oulu University Hospital, Oulu, Finland

  3. 3

    Department of Pediatrics and Adolescence, Oulu University Hospital, Oulu, Finland

  4. 4

    Department of Statistics, University of Oulu, Oulu, Finland

*Department of Neurology, Oulu University Hospital, Box 25, FIN-90290 OYS Oulu, Finland.

Publication History

  1. Issue published online: 9 JUN 2009
  2. Article first published online: 29 APR 2009
  3. Manuscript Accepted: 1 FEB 2009
  4. Manuscript Received: 8 SEP 2008

Funded by

  • Nona and Kullervo Väre Foundation, Finland
  • Foundation for Pediatric Research, Finland
  • Finnish Cancer Society
  • Cancer Society of Northern Finland

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Keywords:

  • acute lymphoblastic leukemia;
  • childhood cancer survivor;
  • follow-up;
  • neurocognitive functioning

Abstract

Background

Despite the extensive literature on neuropsychological sequelae after treatment of childhood acute lymphoblastic leukemia (ALL), the very-long-term neurocognitive outcome of the survivors is poorly studied. We assessed neuropsychological functioning in a population-based cohort of young adult childhood ALL survivors.

Procedure

Neuropsychological testing was performed on 64 survivors an average of 20 years after the diagnosis. The test battery included verbal intelligence quotient (VIQ) and performance intelligence quotient (PIQ), memory function, orientation and attention as well as motor performance. Cranial irradiation had been administered to 44 survivors as part of ALL treatment, whereas 20 survivors had been treated solely with chemotherapy. A control group consisted of 45 healthy young adults. Earlier neuropsychological test results of 45 of the survivors were available for comparison.

Results

The ALL survivors attained significantly lower test scores than the controls in all the neuropsychological function areas. The mean VIQ test scores were 91, 100, and 109 (P < 0.001), and the mean PIQ test scores 100, 111, and 118 (P < 0.001) for the irradiated survivors, non-irradiated survivors and controls, respectively. Memory and motor functions were impaired among the irradiated survivor group compared with the controls. A significant decline in PIQ and VIQ test scores was observed in the irradiated survivor group during the follow-up period, but only in VIQ in the non-irradiated group.

Conclusions

Survivors of childhood ALL suffer from long-lasting progressive neuropsychological impairment, especially when treatment includes cranial irradiation. Pediatr Blood Cancer 2009;53:156–161. © 2009 Wiley-Liss, Inc.

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