Impact of therapeutic and psychological factors on cognitive and behavioral functions in survivors of childhood ALL; post-treatment phase

ABSTRACT

This study was conducted to assess the cognitive and behavioral aspects in leukemic survivors. Twenty children with acute lymphoblastic leukemia [ALL] who are off therapy were included. Intrathecal methotrexate and cranial irradiation [1800 rad] in fractionated doses were used for all children. Twenty healthy age and sex matched children were similarly studied. Good enough, Stanford Binet and Wechsler tests were used to assess the Intelligence state [IQ]. Leukemic survivors showed IQ values comparable to controls except for the total IQ which was higher in leukemic children [P< 0.001]. Childhood behavioral rating scale was applied to evaluate different forms of adjustments. Self and home adjustments were significantly higher in leukemic survivors [P< 0.001] while school adjustment was slightly lower than controls. Cognitive function and learning ability was assessed using progressive matrices, which revealed comparable values. No effect of the parental state of education on IQ, cognitive or behavioral functions were found. A significant positive correlation between age and IQ was found. From the foregoing, it was concluded that combined intrathecal methotrexate and cranial irradiation [1800 rad] can be safely applied with minimal effect on intellectual, behavioral and cognitive function. The bad school performance in these children is due to defect in school adjustment rather than IQ deterioration