Chemotherapy-only treatment effects on long-term neurocognitive functioning in childhood ALL survivors: a review and meta-analysis.

作者: Neel S. Iyer , Lyn M. Balsamo , Michael B. Bracken , Nina S. Kadan-Lottick

DOI: 10.1182/BLOOD-2015-02-627414

关键词:

摘要: Therapy for childhood acute lymphoblastic leukemia (ALL) is associated with 5-year survival rates of ∼90% even after largely eliminating cranial radiation. This meta-analysis assesses the long-term neurocognitive functioning chemotherapy-only regimens among survivors ALL. We conducted a systematic review to identify studies that evaluated following treatment ALL by searching MEDLINE/PubMed, Database Abstracts Reviews Effects, and secondary sources. Studies were included if in continuous first remission, did not receive any radiation, at least ≥2 years off therapy or ≥5 since diagnosis, compared healthy control group. Weighted mean differences 95% confidence intervals (CIs) calculated. Ten nonexperimental met all eligibility criteria 509 patients 555 controls. Meta-analysis demonstrated statistically significant moderate impairment across multiple domains evaluated, intelligence most affected. Significant standard deviation (SD) scores found Full Scale quotient (IQ) (-0.52 SD; CI, -0.68 -0.37), Verbal IQ (-0.54 -0.69 -0.40), Performance (-0.41 -0.56 -0.27); these SD correspond changes 6 8 points. Working memory, information processing speed, fine motor moderately, but significantly, impaired. treated without radiation other domains. Patients their families should be informed about potential negative effects encourage surveillance educational planning. Both preventive intervention strategies are needed.

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