Childhood Leukemia Survivors who were Treated With Chemo Have ADD, Attention Problems

A new study published in the "Journal of Clinical Oncology" shows how pediatric acute lymphoblastic leukemia (ALL) patients who were treated via chemotherapy are still at risk for attention and learning problems years after they receive treatment, Eurekalert reports.

The study, which was the largest and most comprehensive assessment of neurocognitive outcomes in pediatric ALL survivors treated using intensive chemotherapy only to date, was led by researchers at St. Jude Children's Research Hospital.

Leukemia is the most common cancer among the youth, accounting for about one out of three cancers. While childhood leukemia is a rare disease, there are about three out of four cases of ALL among children and teens, according to the American Cancer Society.  

Researchers built on previous St Jude research, studying participants who were enrolled in the t. Jude Total XV protocol from 2000 to 2007. These ALL survivors completed standardized tests of overall intelligence, attention, and learning and academic performance. Only 167 out of the 339 patients eligible for assessments had completed the process at the end of therapy and 24 months later. Researchers, however, did not find any significant differences between those who finished the assessment and those who did not.

According to Medical Xpress, results showed that two years after therapy, ALL survivors performed as expected for their age in terms of overall intelligence, attention, and learning and academic performance, but showed higher risk for attention problems. Parents also reported that their children had increased learning difficulties. In fact, results showed that the risk for attention problems and learning difficulties were most prevalent among survivors who were five years old and younger when they were diagnosed with cancer, and received more intensive chemotherapy.

This type of intensive chemotherapy has high cure rates. In fact, 90% of young ALL patients are still alive 10 years after they were diagnosed with cancer.

"These findings provide additional evidence that neurocognitive functioning has improved in survivors of childhood ALL since cranial irradiation was replaced with intensified chemotherapy," first and corresponding author Dr. Lisa Jacola said. "But we also show these young people are at an elevated risk for attention problems that have real-world consequences, particularly for learning and school performance."

"Attention is a building block for learning, and in this study attention difficulties predicted academic problems later," Dr. Jacola further explained. "This is an important contribution to the literature because the smaller size and design of previous studies made examining the impact of treatment difficult. The findings underscore the need for neurocognitive and academic screening to be included as part of routine survivorship care for all pediatric ALL survivors."