Verbal cognitive functioning and learning in girls treated for acute lymphoblastic leukemia by chemotherapy with or without cranial irradiation
Verbal cognitive functioning and learning in girls treated for acute lymphoblastic leukemia by chemotherapy with or without cranial irradiation
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DOI：
10.1207/s15326942dn2102_4
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发表时间：
2002-01-01
影响因子：
1.5
通讯作者：
Moghrabi, A
中科院分区：
文献类型：
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作者：
Précourt, S;Robaey, P;Moghrabi, A
急性淋巴母细胞性白血病(ALL)治疗后经常出现神经心理学问题，然而，由于先前研究样本的异质性，这些缺陷的具体性质仍然存在争议。然而，这些问题似乎更多地与颅脑放射治疗(CRT)和鞘内化疗(ITC)的组合有关，而不是单独与ITC有关。在这项研究中，我们评估了19名年龄在7岁到11岁之间的同质女孩，在治疗完成30个月后。其中9人接受了头颅放疗和化疗，10人接受了单纯化疗。将这些患者与10名正常健康对照组进行比较。神经心理学测试包括韦氏儿童智力量表第三版(WISC-III)，加州言语学习测试儿童版(CVLT-C)，以及Woodcock-Johnson心理教育成套测验的计算和段落理解分测试-修订版。结果证实，所有接受ITC和CRT联合治疗的女孩都存在语言学习障碍。ITC和CRT组在WISC-III的通道理解分测验和6个言语分测验中的5个分测验上的得分显著低于健康对照组。此外，与未接受照射的患者和健康正常对照组相比，ITC和CRT组在WISC-III的自由分心指数上存在损害，表明存在听觉-语言注意缺陷。在CVLT-C上，ITC和CRT组在学习试验的后半部分与其他两组相比尤其受损，表现出表现平台期。ITC组与健康对照组没有什么不同，这表明ITC单独对语言能力的有害影响较小。在全球范围内，这些结果表明，接受ITC和CRT治疗的女孩存在影响听觉注意力和言语学习的缺陷，这可能表明有必要为这些儿童提供特殊教育援助。
Neuropsychological problems have frequently been reported following treatment of Acute Lymphoblastic Leukemia (ALL), however, partly because of the heterogeneity of the previously studied samples, the specific nature of these deficits is still a matter of debate. These problems, however, appear to be related more to the combination of cranial radiation therapy (CRT) and intrathecal chemotherapy (ITC) than to ITC alone. In this study, we evaluated a homogenous group of 19 girls between the ages of 7 and 11 years, 30 months after the completion of treatment. Nine received cranial radiation and chemotherapy and 10 were treated with chemotherapy alone. The patients were compared to 10 normal healthy controls. Neuropsychological tests included the Wechsler Intelligence Scale for Children-Third Edition (WISC-III), the California Verbal Learning Test-Children's Version (CVLT-C), and the Calculation and Passage Comprehension subtests of the Woodcock-Johnson Psycho-Educational Battery-Revised. Results confirmed the presence of a verbal learning deficit in ALL girls treated with the combination of ITC and CRT. The ITC and CRT group scored significantly lower than the healthy controls on the Passage Comprehension subtest and on 5 of the 6 verbal subtests of the WISC-III. Furthermore, compared to nonirradiated patients and healthy normal controls, the ITC and CRT group was impaired on the Freedom from Distractibility index of the WISC-III, indicating an auditory-verbal attention deficit. On the CVLT-C, the ITC and CRT group was particularly impaired on the second half of the learning trials compared to the other two groups, showing a plateau in their performance. The ITC group was not different from the healthy control group, suggesting a less detrimental effect of the ITC alone on verbal abilities. Globally, these results indicate a deficit affecting auditory attention and verbal learning in girls who receive ITC and CRT, which may suggest the necessity for special educational assistance for these children.