BACKGROUND: Neurocognitive late effects after childhood acute lymphoblastic leukemia (ALL) are well-documented, but their impact on quality of life (QOL) is not well understood. In this multi-site study, we examined the relative influence of neurocognitive functioning, steroid randomization (prednisone vs. dexamethasone), and demographic characteristics on QOL in first-remission survivors of childhood ALL. METHODS: Participants included 263 ALL survivors (ages 7-17 years at the time of evaluation; mean age at diagnosis 3.9 years) who were treated on similar legacy Children's Cancer Group chemotherapy protocols and did not receive cranial radiation. Children completed detailed neuropsychological performance tests. The Pediatric QOL Inventory was completed by children and their parents. Participants were a mean of 9 years from diagnosis at the time of assessment (with a range of 4 to 13 years). RESULTS: Children and their parents reported lower mean child psychosocial QOL than healthy population norms (p < 0.05), but were not in the impaired range. Physical QOL was similar to population norms. Though neurocognitive difficulties were predominantly mild for the sample as a whole, neurocognitive deficits, specifically problems in verbal cognitive abilities and visual-motor integration skills, were significantly associated with poor physical (p < 0.01) and Psychosocial QOL (p < 0.01). QOL was not associated with previous steroid randomization. CONCLUSIONS: ALL survivors with neurocognitive deficits are at risk for poor QOL, with broad implications for their physical, social, and school functioning.
BACKGROUND: Neurocognitive late effects after childhood acute lymphoblastic leukemia (ALL) are well-documented, but their impact on quality of life (QOL) is not well understood. In this multi-site study, we examined the relative influence of neurocognitive functioning, steroid randomization (prednisone vs. dexamethasone), and demographic characteristics on QOL in first-remission survivors of childhood ALL. METHODS:Participants included 263 ALL survivors (ages 7-17 years at the time of evaluation; mean age at diagnosis 3.9 years) who were treated on similar legacy Children's Cancer Group chemotherapy protocols and did not receive cranial radiation. Children completed detailed neuropsychological performance tests. The Pediatric QOL Inventory was completed by children and their parents. Participants were a mean of 9 years from diagnosis at the time of assessment (with a range of 4 to 13 years). RESULTS:Children and their parents reported lower mean child psychosocial QOL than healthy population norms (p < 0.05), but were not in the impaired range. Physical QOL was similar to population norms. Though neurocognitive difficulties were predominantly mild for the sample as a whole, neurocognitive deficits, specifically problems in verbal cognitive abilities and visual-motor integration skills, were significantly associated with poor physical (p < 0.01) and Psychosocial QOL (p < 0.01). QOL was not associated with previous steroid randomization. CONCLUSIONS: ALL survivors with neurocognitive deficits are at risk for poor QOL, with broad implications for their physical, social, and school functioning.
Authors: Lisa M Jacola; Kim Edelstein; Wei Liu; Ching-Hon Pui; Robert Hayashi; Nina S Kadan-Lottick; Deokumar Srivastava; Tara Henderson; Wendy Leisenring; Leslie L Robison; Gregory T Armstrong; Kevin R Krull Journal: Lancet Psychiatry Date: 2016-09-14 Impact factor: 27.083
Authors: Kris Ann P Schultz; Lu Chen; Alicia Kunin-Batson; Zhengjia Chen; William G Woods; Alan Gamis; Toana Kawashima; Kevin C Oeffinger; H Stacy Nicholson; Joseph P Neglia Journal: J Pediatr Hematol Oncol Date: 2017-01 Impact factor: 1.289
Authors: Sunita K Patel; Leticia Miranda; Nicole Delgado; Nicolas Barreto; Anne Nolty; Natalie C Kelly; Karla Wilson; Debbie Toomey; Anna Pawlowska Journal: J Pediatr Psychol Date: 2020-09-01
Authors: J Vetsch; C E Wakefield; E G Robertson; T N Trahair; M K Mateos; M Grootenhuis; G M Marshall; R J Cohn; J E Fardell Journal: Qual Life Res Date: 2018-01-25 Impact factor: 4.147
Authors: Ellen van der Plas; Brian J Nieman; Darci T Butcher; Johann K Hitzler; Rosanna Weksberg; Shinya Ito; Russell Schachar Journal: J Can Acad Child Adolesc Psychiatry Date: 2015-03-04