Artikel: The contribution of neurocognitive functioning to quality of life after childhood acute lymphoblastic leukemia
Door annelies_verachtert op Ma, 30/06/2014 - 00:00
Abstract: Neurocognitive late effects after childhood acute lymphoblastic leukemia (ALL) are well- documented, but their impact on quality of life (QOL) is not well understood. In this multi-site study, we examined the relative influence of neurocognitive functioning, steroid randomization (prednisone vs. dexamethasone), and demographic characteristics on QOL in first-remission survivors of childhood ALL.
Methods: Participants included 263 ALL survivors (ages 7–17 years at the time of evaluation; mean age at diagnosis 3.9 years) who were treated on similar legacy Children’s Cancer Group chemotherapy protocols and did not receive cranial radiation. Children completed detailed neuropsychological perfor- mance tests. The Pediatric QOL Inventory was completed by children and their parents. Participants were a mean of 9 years from diagnosis at the time of assessment (with a range of 4 to 13 years).
Results: Children and their parents reported lower mean child psychosocial QOL than healthy population norms (p < 0.05), but were not in the impaired range. Physical QOL was similar to popu- lation norms. Though neurocognitive difficulties were predominantly mild for the sample as a whole, neurocognitive deficits, specifically problems in verbal cognitive abilities and visual-motor integration skills, were significantly associated with poor physical (p<0.01) and Psychosocial QOL (p<0.01). QOL was not associated with previous steroid randomization.
Conclusions: ALL survivors with neurocognitive deficits are at risk for poor QOL, with broad im- plications for their physical, social, and school functioning.
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