Prevention and Improvement of Cognitive Deficits in Childhood Acute Lymphoblastic Leukemia (All) Survivors Treated With Chemotherapy: Evidence-Based Information For Parents

Abstract

This thesis summarizes what is known about the cognitive changes in childhood acute lymphoblastic leukemia (ALL) survivors treated with chemotherapy, as well as associated risk factors and intervention strategies. An educational pamphlet was developed compiling this information to serve as anticipatory guidance for parents of children diagnosed with ALL. ALL is a cancer of the blood and bone marrow and is the most common pediatric malignancy, accounting for 25% of cancers in children under 15 years of age. Treatments are extremely successful, with survival rates of 90% for children younger than 15 years. Unfortunately, treatment side effects increase with the increase of survival rates. Ureatmentrelated cognitive deficits occur in up to 40% of childhood ALL survivors, and is becoming increasingly common. Results from the literature review indicate that children with ALL treated with chemotherapy have cognitive impairment in the areas of total intelligence quotient (IQ), working memory, attention, information processing speed, fine motor speed, visual IQ, verbal IQ, performance IQ, problem solving, and sequential reasoning. These cognitive problems can have a significant impact on the child’s quality of life and transition back to school after treatment. Interventions that are effective in improving cognitive outcomes include cognitive and/or problem-solving interventions.