Conflict of interest: Nothing to declare.
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†
Article first published online: 30 JUN 2011
Copyright © 2011 Wiley Periodicals, Inc.
Pediatric Blood & Cancer
Volume 58, Issue 5, pages 758–765, May 2012
How to Cite
Waber, D. P., Queally, J. T., Catania, L., Robaey, P., Romero, I., Adams, H., Alyman, C., Jandet-Brunet, C., Sallan, S. E. and Silverman, L. B. (2012), 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. Pediatr. Blood Cancer, 58: 758–765. doi: 10.1002/pbc.23234
- Issue published online: 4 MAR 2012
- Article first published online: 30 JUN 2011
- Manuscript Accepted: 18 MAY 2011
- Manuscript Received: 15 FEB 2011
- National Cancer Institute. Grant Number: 2 P01 CA 68484
- Michael J. Garil Fund for Leukemia Research
- National Institute of Child Health and Development. Grant Number: P30-HD18655
- acute lymphoblastic leukemia;
- risk group
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.
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.
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.
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. Pediatr Blood Cancer 2012; 58: 758–765. © 2011 Wiley Periodicals, Inc.