Effects of different forms of central nervous system prophylaxis on neuropsychologic function in childhood leukemia

Journal Article · Sat Dec 01 04:00:00 EST 1984 · J. Clin. Oncol.; (United States)

OSTI ID:5832049

Rowland, J H; Glidewell, O J; Sibley, R F; Holland, J C; Tull, R; Berman, A; Brecher, M L; Harris, M; Glicksman, A S; Forman, E

A comparison of the late effects on intellectual and neuropsychologic function of three different CNS prophylaxis regimens was conducted in 104 patients treated for childhood acute lymphocytic leukemia. Of the children studied, 33 were randomized to treatment with intrathecal (IT) methotrexate alone, 36 to IT methotrexate plus 2,400 rad cranial irradiation, and 35 to IT methotrexate plus intravenous intermediate dose methotrexate. All patients were in their first (complete) continuous remission, were a minimum of one year post-CNS prophylaxis and had no evidence of CNS disease at the time of evaluation. In contrast to the other two treatment groups, children whose CNS prophylaxis included cranial irradiation attained significantly lower mean Full Scale IQs, performed more poorly on the Wide Range Achievement Test, a measure of school abilities, and exhibited a greater number of difficulties on a variety of other neuropsychologic measures. The poorer performance of the irradiated group was independent of sex of the patient, time since treatment and age at diagnosis. These data suggest that the addition of 2,400 rad cranial irradiation to CNS prophylaxis in ALL puts these children at greater risk for mild global loss in intellectual and neuropsychologic ability.

• Research Organization: Memorial Sloan-Kettering Cancer Center, New York, NY
• OSTI ID: 5832049
• Journal Information: J. Clin. Oncol.; (United States), Journal Name: J. Clin. Oncol.; (United States) Vol. 2:12; ISSN JCOND
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
AGE GROUPS
ANTIMETABOLITES
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
BRAIN
CENTRAL NERVOUS SYSTEM
CHEMOTHERAPY
CHILDREN
COMPARATIVE EVALUATIONS
DISEASES
DRUGS
EXTERNAL IRRADIATION
HEMIC DISEASES
INJURIES
IRRADIATION
LEUKEMIA
MEDICINE
METHOTREXATE
NEOPLASMS
NERVOUS SYSTEM
NUCLEAR MEDICINE
ORGANS
PERFORMANCE
RADIATION EFFECTS
RADIATION INJURIES
RADIOLOGY
RADIOTHERAPY
SIDE EFFECTS
THERAPY