Declines in IQ scores and cognitive dysfunctions in children with acute lymphocytic leukaemia treated with cranial irradiation.
Declines in IQ scores and cognitive dysfunctions in children with acute lymphocytic leukaemia treated with cranial irradiation.
复制标题
接受颅脑照射治疗的急性淋巴细胞白血病儿童的智商评分下降和认知功能障碍。
DOI：
10.1016/s0140-6736(81)91216-2
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发表时间：
1981
期刊：
影响因子：
--
通讯作者：
Moss,K
中科院分区：
文献类型：
--
作者：
Meadows,AT;Gordon,J;Massari,DJ;Littman,P;Fergusson,J;Moss,K
在儿童急性淋巴细胞白血病(ALL)的幸存者中观察到了智力和其他神经心理功能障碍。在费城儿童医院新诊断的ALL儿童的前瞻性研究中，研究了治疗与这些功能障碍的可能关系。在治疗的第一个月和之后定期进行标准化的智力测试对他们进行评估。有两个治疗计划-一个使用标准药物进行诱导和维持，另一个使用更密集的治疗计划。所有患者均接受中枢神经系统预防治疗(2400rad头颅照射和6剂鞘内甲氨蝶呤注射)。大多数儿童的整体智商得分显著下降，年龄较小的患者受到的影响最大。对幸存下来的儿童进行了更广泛的测试，包括智商下降和不下降的儿童，他们在第一次测试中都是正常的，发现了功能缺陷和剩余力量的模式，而这些模式不能仅靠智商测试来表征。这些可能会影响学习和学习成绩的缺陷，在接受类似化疗(包括鞘内和口服甲氨蝶呤，但不包括头颅照射)的六名儿童中没有出现。
Intellectual and other neuropsychological dysfunctions have been observed in survivors of childhood acute lymphocytic leukaemia (ALL). The possible relationship of therapy to these dysfunctions was investigated in a prospective study of children with newly diagnosed ALL seen at the Children's Hospital of Philadelphia. They were evaluated with standardised intelligence tests during the first month of treatment and periodically thereafter. There were two therapy schedules—one using standard drugs for induction and maintenance, the other a more intensive schedule. Central-nervous-system prophylaxis (2400 rad cranial radiation and six doses of intrathecal methotrexate) was given to all. Significant reductions were found in overall IQ score for the majority of children, younger patients being most affected. More extensive testing of surviving children, with and without decline in IQ, all of whom were normal on the first test, revealed patterns of functional deficits and residual strengths that could not be characterised with IQ testing alone. These deficits, which could affect learning and academic performance, were not seen in six children studied years after receiving similar chemotherapy that included intrathecal and oral methotrexate but not cranial irradiation.