Neuropsychologic sequelae in the long-term survivors of childhood acute lymphoblastic leukemia

The neurotoxicity of either systemic chemotherapy or central nervous system prophylaxis was studied in 19 children treated for acute lymphoblastic leu kemia (ALL). They had completed ALL therapy at least a year before and surv ived more than 5 pears after diagnosis. The duration between age at diagnos is and age at investigation was 8.6 +/- 2.7 years (5-15 years). Neuropsycho logic tests, cranial magnetic resonance imaging (MRI), and evoked potential s (EP) were studied. Seventeen healthy siblings were taken as a control gro up. Emotional evaluation was done using the childhood depression inventory and Beck depression inventory. Cognitive functions were evaluated using Wec hsler's Intelligence Scale for Children-Revised (WISC-R) or the Wechsler's Adult Intelligence Scale-Revised (WAIS-R) tests, which were adapted to Turk ish children. Performance and total IQ scores (94.0 +/- 16.8 and 92.2 +/- 1 6.5) were significantly low as compared to the control group (112.1 +/- 18. 9 and 105.4 +/- 14.2) (p = .007 and p = .02). Abnormal MRI findings were fo und in 33.3 % (6/18). Three out of 18 patients (16.6%) had abnormal auditor y while 5 out of 17 Patients (29.5%) displayed abnormal visual EPs. Abnorma l findings in MRI, cognitive examination, and electrophysiologic testing we re not associated with age at diagnosis, radiotherapy doses, intermediate/h igh-dose systemic methotrexate administration or central nervous system inv olvement. But more patients must be studied to demonstrate discrete outcome s of neurotoxicity In long-term survivors of childhood le leukemia.