BACKGROUND: Pediatric cancer survivors are at increased risk of various neurological and psychological problems. The prevalence of behavioral problems was assessed in a longitudinal study in pediatric patients with an acute lymphoblastic leukemia (ALL). Multilevel modeling was used to identify associated predictive factors. PROCEDURE: ALL patients and their parents (n = 138) took part to this study. Patients were treated according to the Dana-Farber Cancer Institute (DFCI) consortium protocols 91-01 or 95-01. Mothers filled out questionnaires providing a measure of behavioral problems for their child at diagnosis and during the subsequent 4 years, and of their perceived familial stress at diagnosis and post-induction. RESULTS: Prevalence of internalized behavioral problems at diagnosis was increased [42% above 1 standard deviation (SD); P < 0.001], but it normalized over time. Internalized problems resolved more slowly in the presence of medical variables associated with increased stress related to the disease (hospitalization duration, P < 0.001; relapse risk at diagnosis, P < 0.001). Externalized behavioral problems were within the expected normal range, but more sustained over time with the 95-01 than with the 91-01 treatment protocols (P < 0.05), likely due to the type of corticosteroid (CS) used (dexamethasone vs. prednisone). CONCLUSIONS: Assessment of both internalized and externalized problems is required in this population. The impact of pharmacological variables on externalized behavioral problems is likely related to CS use.
BACKGROUND: Pediatric cancer survivors are at increased risk of various neurological and psychological problems. The prevalence of behavioral problems was assessed in a longitudinal study in pediatric patients with an acute lymphoblastic leukemia (ALL). Multilevel modeling was used to identify associated predictive factors. PROCEDURE: ALL patients and their parents (n = 138) took part to this study. Patients were treated according to the Dana-Farber Cancer Institute (DFCI) consortium protocols 91-01 or 95-01. Mothers filled out questionnaires providing a measure of behavioral problems for their child at diagnosis and during the subsequent 4 years, and of their perceived familial stress at diagnosis and post-induction. RESULTS: Prevalence of internalized behavioral problems at diagnosis was increased [42% above 1 standard deviation (SD); P < 0.001], but it normalized over time. Internalized problems resolved more slowly in the presence of medical variables associated with increased stress related to the disease (hospitalization duration, P < 0.001; relapse risk at diagnosis, P < 0.001). Externalized behavioral problems were within the expected normal range, but more sustained over time with the 95-01 than with the 91-01 treatment protocols (P < 0.05), likely due to the type of corticosteroid (CS) used (dexamethasone vs. prednisone). CONCLUSIONS: Assessment of both internalized and externalized problems is required in this population. The impact of pharmacological variables on externalized behavioral problems is likely related to CS use.
Authors: Deborah P Waber; Marie McCabe; Mikaela Sebree; Peter W Forbes; Heather Adams; Cheryl Alyman; Stephen A Sands; Philippe Robaey; Ivonne Romero; Marie-Ève Routhier; Jonathan M Girard; Stephen E Sallan; Lewis B Silverman Journal: Pediatr Blood Cancer Date: 2013-07-06 Impact factor: 3.167
Authors: Alicia S Kunin-Batson; Xiaomin Lu; Lyn Balsamo; Kelsey Graber; Meenakshi Devidas; Stephen P Hunger; William L Carroll; Naomi J Winick; Leonard A Mattano; Kelly W Maloney; Nina S Kadan-Lottick Journal: Cancer Date: 2016-03-29 Impact factor: 6.860
Authors: Simone M Sint Nicolaas; Peter M Hoogerbrugge; Esther M M van den Bergh; José A E Custers; Sofia Gameiro; Reinoud J B J Gemke; Chris M Verhaak Journal: Support Care Cancer Date: 2016-06-14 Impact factor: 3.603