ABSTRACT
We evaluated the behavior of 38 children with standard-risk and high-risk acute lymphoblastic leukemia who received corticosteroids as part of their antileukemia chemotherapy. Each patient was assessed on two occasions: 16 weeks following remission and 1 year thereafter. Parent reports on emotional lability, attention span/hyperactivity, sleep disturbance, listlessness, peer relations, and depressed mood were obtained for 4 consecutive weeks: week before, week during, and 2 weeks after treatment administration. At the 16 week evaluation, standard-risk (N = 17) and high-risk (N = 21) treatment differed by steroid dose and systemic chemotherapy, while at the 1 year testing, treatment differed only by steroid dose (prednisone 40 mg/m2 vs. 120 mg/m2). Statistically significant changes in all measures were observed during treatment as compared with before and after treatment for both risk groups and assessment times. High-risk patients exhibited greater behavioral effects than standard-risk patients only for emotional lability, listlessness, and depressed mood at the 16 week testing, when both steroid dose and chemotherapy differed. Girls had slightly greater behavioral effects than boys, while no influence of age was observed. At the doses tested, steroid dose per se does not appear to be the primary variable affecting behavioral changes.
Subject(s)
Child Behavior/drug effects , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Prednisone/adverse effects , Age Factors , Analysis of Variance , Attention/drug effects , Child , Child, Preschool , Cytarabine/therapeutic use , Depression/chemically induced , Doxorubicin/therapeutic use , Drug Interactions , Emotions/drug effects , Female , Humans , Infant , Interpersonal Relations , Male , Mercaptopurine/therapeutic use , Methotrexate/therapeutic use , Precursor Cell Lymphoblastic Leukemia-Lymphoma/radiotherapy , Prednisone/therapeutic use , Prospective Studies , Sex Factors , Sleep/drug effects , Vincristine/therapeutic useABSTRACT
Compared 56 children between the ages of 5 and 12 years to a sample of healthy controls. All cancer patients had been treated between the ages of 2 and 5 years. Children completed the Self-Perception Profile for children and questionnaires assessing social adjustment. Parent and teacher ratings were also obtained. The cancer patients reported greater feelings of isolation than the controls but otherwise few differences were noted. There were few differences between cancer patients and controls in the teacher and parent report. Results are discussed in terms of the need to investigate behavioral sequelae of childhood illness and directions for future research.
