10-YEAR SURVEY OF THE INTELLECTUAL DEFICITS IN CHILDREN WITH ACUTE LYMPHOBLASTIC-LEUKEMIA RECEIVING CHEMOIMMUNOTHERAPY

Effects of chemoimmunotherapy, including cranial irradiation for centr al nervous system (CNS)-directed therapy, on children with acute lymph oblastic leukemia (ALL) were investigated. Fifty-five children with AL L in continuous complete remission (>5 yr) and without evidence of cur rent or past CNS diseases were evaluated in this retrospective study. Using standard measures of intelligence (IQ), we repeatedly (1-4 times /person; mean 2.1 times) evaluated IQ in the cohort of patients for th e mean follow-up time of 9.7 yr, ranging from 5.4 to 15.8 yr. Fifty-fi ve patients received the total number of 118 IQ testings and 40 patien ts received them more than twice. Patients were examined periodically at intervals of 1.4 to 10.0 yr (mean 4.8 yr) following diagnosis. Most of the published studies dealt with single IQ testing, and long-term follow-ups were not enough to assess the consequent IQ change. This re port confirms and extends the previous findings: decreased IQ was rela ted to age at diagnosis and irradiation (<5 yr of age at diagnosis), i rradiation-examination interval, and female sex. Further long-term fol low-up study will be needed in these groups, since their IQs are still on the decline even after 10 yr of diagnosis. (C) 1993 Wiley-Liss, In c.