Intellectual and mathematical functioning as impacted by central nervous system prophylactic chemotherapy for acute lymphoblastic leukemia

Abstract

Acute lymphoblastic leukemia (ALL), the most common childhood cancer, is currently survivable in approximately 70 percent of cases. Better therapeutic regimes are responsible for improved survival rates, and therapy has been refined throughout the past 30 years to reflect the balance struck between effective treatment and possible adverse side effects. Current treatment protocols for standard-risk patents usually consist of either intrathecal (IT) or intravenous (IV) chemotherapy, or both. Chemotherapy without cranial radiation therapy (CRT) is a relatively new form of treatment, and no consensus has been reached about its possible adverse effects on IQ or academic achievement. When deficits in academic achievement are found, they tend to differentially manifest in the area of mathematics rather than language skills. However, none of the studies examining mathematics achievement in ALL survivors have used a comprehensive test to evaluate mathematics functioning. Thus, fifteen children (x = 11.86 years) who are long-term ALL survivors, and 15 comparison group children (x = 11.75 years) were tested on a measures of general intellectual functioning, mathematics achievement, spelling, word usage and single word reading. Survivors of ALL consistently demonstrated significantly lower scores on measures of IQ and mathematics achievement. No significant differences between groups on measures of spelling, word usage, and word reading were found. Further studies that address neuropsychological functioning in ALL survivors could help to illuminate the specific abilities responsible for these decrements.