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1.
Curr Pediatr Rev ; 14(4): 253-260, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30381081

RESUMO

INTRODUCTION: Subtle neurocognitive deficits have been recently observed in Acute Lymphoblastic Leukemia (ALL) survivors. AIM: We aim to assess the neurocognitive functions of ALL survivors who had been treated with chemotherapy only using two different protocols, and to identify treatment-related risk factors. PATIENTS AND METHODS: We carried a multicenter study involving 3 pediatric oncology centers on 100 children who were treated for ALL. Fifty patients were treated by the modified Children's Cancer Group (CCG) 1991 protocol with low dose methotrexate and 50 children were treated by Total XV protocol with high dose methotrexate. Fifty healthy children were included as a control group. Psychometric assessment using Arabic version of Wechsler intelligence scale for children (WISC III) was performed for all patients and controls. RESULTS: Patients had significantly lower mean full scale IQ, performance IQ and verbal IQ than controls. Patients ≤ 5 years at diagnosis had significantly lower mean full scale IQ and performance IQ than patients>5 years at diagnosis, while the verbal IQ showed no significant difference between both age groups. Female patients had significantly lower mean full scale IQ, performance IQ and verbal IQthan males. Patients who received Total XV protocol with high dose methotrexate had significantly lower mean full scale IQ, performance IQ and verbal IQ than patients who received modified CCG 1991 protocol with low dose methotrexate. CONCLUSIONS: CNS directed chemotherapy might appear to affect neurocognitive functions in children with ALL, which is more significant in young children at diagnosis, in girls and in those receiving high dose methotrexate.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Metotrexato/administração & dosagem , Transtornos Neurocognitivos/tratamento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Adolescente , Sobreviventes de Câncer , Criança , Pré-Escolar , Cognição/efeitos dos fármacos , Estudos Transversais , Egito , Feminino , Humanos , Testes de Inteligência , Masculino , Transtornos Neurocognitivos/etiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Psicometria/métodos , Resultado do Tratamento
2.
J Child Neurol ; 30(4): 417-22, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25296920

RESUMO

Multiple risk factors contribute to cognitive impairment in children with ß-thalassemia major. For a more refined understanding of this issue, we attempted to evaluate cognitive function in ß-thalassemia major patients and identify the relationship between possible cognitive dysfunction and the following: demography, transfusion and chelation characteristics, iron overload, and disease complications. We studied 100 ß-thalassemia major children and 100 healthy controls who matched well in terms of age, sex, and socioeconomic status. All participants underwent psychometric assessment using Wechsler Intelligence Scale for Children-Third Edition, Arabic version. The mean Full-Scale IQ and Performance IQ of patients were significantly lower than those of controls, whereas no significant difference was found for Verbal IQ. No significant relationship existed between IQ and any of the assessed parameters. We concluded that Performance IQ, not Verbal IQ, was significantly affected in ß-thalassemia major patients, but there was no clear association between IQ and any of the parameters.


Assuntos
Talassemia beta/psicologia , Criança , Transtornos Cognitivos/complicações , Transtornos Cognitivos/metabolismo , Estudos Transversais , Escolaridade , Feminino , Humanos , Testes de Inteligência , Masculino , Psicometria , Fatores Sexuais , Fatores Socioeconômicos , Talassemia beta/complicações , Talassemia beta/metabolismo , Talassemia beta/terapia
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