Long-term survivors of leukemia treated in infancy: factors associated with neuropsychologic status.

1992 ◽  
Vol 10 (7) ◽  
pp. 1095-1102 ◽  
Author(s):  
R K Mulhern ◽  
E Kovnar ◽  
J Langston ◽  
M Carter ◽  
D Fairclough ◽  
...  
Keyword(s):  
Young Children ◽  
Wilms Tumor ◽  
Lymphoblastic Leukemia ◽  
Memory Performance ◽  
Auditory Memory ◽  
Very Young Children ◽  
Cns Relapse ◽  
Neuropsychologic Testing ◽  
Long Term Survivors

PURPOSE Because of concerns about late toxicities of treatment among infants diagnosed with acute lymphoblastic leukemia (ALL), and especially the effects of cranial radiation therapy (CRT), we compared the functional and neuropsychologic status of 26 long-term survivors of ALL who were diagnosed in the first 24 months of life versus 26 children who were treated previously for Wilms' tumor. PATIENTS AND METHODS Of the children with ALL, CNS prophylaxis included no CRT in six, 18 Gy CRT in five, 20 Gy CRT in seven, and 24 Gy CRT in five. Three additional children experienced CNS relapse and received total CRT doses of 24, 40, and 44 Gy. All children received neuropsychologic testing; children with ALL also participated in diagnostic imaging studies. RESULTS As a group, the children who were treated for ALL did not differ significantly from those who were treated for Wilms' tumor on objective measures of global functional status. However, children treated for ALL had a significantly lower mean intelligence quotient (IQ) (87 v 96), poorer performance on four of six measures of visual and auditory memory, lower achievement with regard to arithmetic skills, and a greater frequency of special educational intervention than those who were treated for Wilms' tumor. IQ and auditory memory performance in the ALL group was correlated inversely with time since the completion of therapy and total CRT dose. CONCLUSIONS These results reinforce the contemporary trend of prophylactic CRT omission in very young children except for those who are at risk for CNS relapse. For infants and very young children who require CRT, evidence is presented that supports the approach for the delay of CRT until the child is older.

scholarly journals Nutritional status and physical activity of childhood leukemia survivors

2014 ◽  
Vol 54 (2) ◽  
pp. 67
Author(s):  
Conny Tanjung ◽  
Johannes Bondan Lukito ◽  
Prima Dyarti Meylani
Keyword(s):  
Physical Activity ◽  
Nutritional Status ◽  
Childhood Leukemia ◽  
Lymphoblastic Leukemia ◽  
Induction Phase ◽  
Childhood All ◽  
Increased Risk ◽  
Long Term Survivors ◽  
First Time

Background Acute lymphoblastic leukemia (ALL), the mostcommon malignancy of childhood, has an overall cure rate ofapproximately 80%. Long-term survivors of childhood ALL areat increased risk for obesity and physical inactivity that may leadto the development of diabetes, dyslipidemia, metabolic syndrome,as well as cardiovascular dis eases, and related mortality in theyears following treatment.Objective To evaluate the physical activity and the propensityfor developing obesity longer term in ALL survivors.Methods This retrospective cohort study included all ALLsurvivors from Pantai Indah Kapuk (PIK) Hospital. We assessedtheir physical activity and nutritional status at the first time ofALL diagnosis an d at the time of interview.Results Subjects were 15 ALL survivors aged 7 to 24 years. Themedian fo llow up time was 6.4 years (range 3 to 10 years). Only2 out of 15 survivors were overweight and n one were obese.All survivors led a sedentary lifestyle. Most female subjectshad increased BMI, though most were not overweight/obese.Steroid therapy in the induction phase did not increase the riskof developing obesity in ALL survivors.Conclusion Lon g-term survivors of childh ood ALL do not meetphysical activity recommendations according to the CDC (Centersfor Disease Control). Howevei; steroid therapy do not seem tolead to overweight/obesity in ALL survivors.

Neurocognitive Outcome in Very Long-Term Survivors of Childhood Acute Lymphoblastic Leukemia After Treatment with Chemotherapy Only

2015 ◽  
Vol 63 (1) ◽  
pp. 133-138 ◽  
Author(s):  
Adriani Kanellopoulos ◽  
Stein Andersson ◽  
Bernward Zeller ◽  
Christian K. Tamnes ◽  
Anders M. Fjell ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Childhood Acute Lymphoblastic Leukemia ◽  
Neurocognitive Outcome ◽  
Long Term Survivors

Neuropsychological Late Effects

2006 ◽  
Author(s):  
Raymond K. Mulhern ◽  
Robert W. Butler
Keyword(s):  
Brain Tumors ◽  
Childhood Cancer ◽  
Late Effects ◽  
Lymphoblastic Leukemia ◽  
Future Research ◽  
Cognitive Changes ◽  
Neuropsychological Status ◽  
Neurobiological Substrates ◽  
Long Term Survivors

This chapter reviews neuropsychological late effects associated with childhood cancer and its treatment. The study of late effects presupposes that patients are long-term survivors, if not permanently cured, of their disease. Late effects are temporally defined as occurring after the successful completion of medical therapy, usually 2 or more years from the time of diagnosis, and it is generally assumed that late effects are chronic, if not progressive, in their course. This definition serves to separate late effects from those effects of disease and treatment that are acute or subacute and time limited, such as chemotherapy-induced nausea and vomiting or temporary cognitive changes induced by cancer therapy. Research interest in neuropsychological outcomes, as well as neurological and other functional late effects, has shown an increase commensurate with improvements in effective therapy. For example, 30 years ago when few children were cured of acute lymphoblastic leukemia (ALL), questions related to the ultimate academic or vocational performance of long-term survivors were trivial compared to the need for improved therapy. In contrast, today more than 80% of children diagnosed with ALL can be cured, and issues related to their quality of life as long-term survivors have now received increased emphasis. There is at least comparable attention to neuropsychological status in primary brain tumors. We first provide a brief medical background on the two most frequent forms of childhood cancer, ALL and malignant brain tumors, followed by a review of the current neuropsychological literature. The literature review provides an in-depth analysis of the types of cognitive impairments observed and known or suspected risk factors for impairments. When neurobiological substrates are known, particularly from neuroimaging studies, they are discussed. Finally, we conclude the review with sections that discuss current recommendations for a core battery of neuropsychological assessment of survivors and recommendations for future research. Approximately 20,000 children and adolescents under the age of 20 years were diagnosed with cancer in 1999 (Steen & Mirro, 2000). The most commonly diagnosed cancer in this age group is ALL, a malignant disorder of lymphoid cells found in the bone marrow that migrates to virtually every organ system, including the central nervous system (CNS), via the circulatory system. ALL accounts for one fourth of all childhood cancers and 75% of all cases of childhood leukemia (Margolin, Steuber, & Poplack, 2002).

Adolescents and Young Adults with Acute Lymphoblastic Leukemia

Hematology ◽  
2010 ◽  
Vol 2010 (1) ◽  
pp. 21-29 ◽  
Author(s):  
Wendy Stock
Keyword(s):  
Young Adults ◽  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Adolescents And Young Adults ◽  
Adult Treatment ◽  
Younger Adults ◽  
Disease Biology ◽  
Current Therapies ◽  
Long Term Survivors

Abstract During the last decade, increasing attention has been paid to a unique group of patients with acute lymphoblastic leukemia (ALL) who lie at the crossroad of therapeutic care by pediatric and adult hematologists/oncologists. ALL is a disease that affects infants, children, adolescents, and adult patients. With current therapies, the vast majority of children with ALL are now long-term survivors; unfortunately, the same good results have not yet been obtained for adults with ALL. This review will describe current controversies surrounding the treatment of adolescents and young adults with ALL—a group who finds themselves in the transition from “pediatric” to “adult” treatment approaches. The review focuses on recent insights into disease biology, prognostic factors, and treatment outcomes that have led to a series of prospective clinical trials specifically designed for adolescents and younger adults (AYAs) with ALL. These trials have been designed to provide important new clinical, psychosocial, and biological insights, and to further improve the survival of this challenging and unique group of patients.

scholarly journals Asymptomatic kidney stones in long-term survivors of childhood acute lymphoblastic leukemia

Leukemia ◽  
2008 ◽  
Vol 23 (1) ◽  
pp. 104-108 ◽  
Author(s):  
S C Kaste ◽  
N A Thomas ◽  
S N Rai ◽  
K Cheon ◽  
E McCammon ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Kidney Stones ◽  
Lymphoblastic Leukemia ◽  
Childhood Acute Lymphoblastic Leukemia ◽  
Long Term Survivors
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