Longitudinal, multimodal assessment of neuropsychological functioning in children diagnosed with high-risk acute lymphoblastic leukemia (HR-ALL): Using early changes to predict later impairment

对诊断为高危急性淋巴细胞白血病 (HR-ALL) 的儿童的神经心理功能进行纵向、多模式评估：利用早期变化预测后期损伤

• 批准号: 10170282
• 负责人: Leanne Embry
• 金额: $ 37.04万
• 依托单位: CHILDREN'S RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-06 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10170282
• 关键词: Accounting; Acute Lymphocytic Leukemia; Address; Affect; Aftercare; Age; Child; Childhood; Clinical Practice Guideline; Cognitive; Cognitive deficits; Development; Diagnosis; Disease; Early Diagnosis; Early Intervention; Education; Employment; Evaluation; Event; Family; Fatigue; Goals; Health; Hour; Impairment; Individual; Institute of Medicine (U.S.); Insurance; Intervention; Investigation; Late Effects; Learning; Learning Skill; Life; Literature; Maintenance; Malignant Childhood Neoplasm; Malignant Neoplasms; Marriage; Measures; Medical; Memory; Mental Health; Methods; Modeling; Modernization; Monitor; Morbidity - disease rate; Neuraxis; Neurocognitive; Neurocognitive Deficit; Neurologic; Neuropsychology; Occupational; Office Nursing; Outcome; Pain; Patient risk; Patients; Pattern; Performance; Population; Protocols documentation; Psychologist; Public Health; Quality of life; Reporting; Research Personnel; Resources; Risk; Risk Factors; Sample Size; Savings; Seizures; Social Adjustment; Socioeconomic Status; Source; Specific qualifier value; Survival Rate; Survivors; Symptoms; Testing; Thinking; Time; Training; cognitive function; cognitive testing; computerized; cost; cost effective; emotional distress; evidence base; functional outcomes; high risk; innovation; interest; leukemia; leukemia treatment; multimodality; neglect; novel; programs; prospective; psychosocial; relapse risk; remediation; screening; social; success; therapy development; young adult

PROJECT SUMMARY Children with “high-risk” leukemia receive intense treatments that, while life-saving, can also cause them to develop problems with the way they learn and think. This does not happen to all children receiving these treatments, but we cannot yet predict who will develop problems. One reason that we lack this information is that it is often difficult to test changes in the way children learn while they are receiving medical treatment. Children may feel too sick to complete testing, psychologists are not always available to do the evaluations, and insurance companies may not cover the testing that is needed. In this project, we aim to identify the first signs of changes in thinking and learning using a short, computerized testing program. The tests can be given in clinic by nurses or other staff, and cost very little money. We will test children starting shortly after leukemia is diagnosed, and several times during the course of their treatment, so that we can identify problems as soon as they start to occur. Children in our study will also receive a one-hour evaluation with widely-used tests of learning and memory, given by a psychologist, five years after their diagnosis. We will determine whether results from the computerized tests are able to predict performance on the more traditional tests given by the psychologists. If computerized testing done early in treatment helps us to better predict who will go on to have difficulties, we can help to slow down or eliminate these problems. Finally, we want to determine the extent to which other factors also contribute to problems that develop as a result of leukemia treatment. We are especially interested in looking at factors known to affect children's thinking and learning skills, like a family's access to resources, mental health difficulties, and medical problems that can occur during treatment. We will also be asking children to tell us about how tired, sick, or in pain they are right before they complete the computerized testing program. Because there is some evidence indicating that these types of symptoms may affect children's performance on cognitive tests, we believe that it's important to describe any impact that these symptoms have on children's thinking and learning, both early in treatment and also much later. If we can better understand how all of these factors relate to survivors' patterns of thinking and learning, we can better predict which individuals may be affected by those problems.

项目总结 患有高危白血病的儿童接受强化治疗，在挽救生命的同时，还可以 导致他们在学习和思考方式上出现问题。这并不是所有人都会发生的 接受这些治疗的儿童，但我们还不能预测谁会出现问题。一 我们缺乏这些信息的原因是，通常很难测试儿童方式的变化 在他们接受治疗的同时学习。孩子们可能会觉得病得太重，无法完成测试， 心理学家并不总是可以进行评估，保险公司也可能不会 涵盖所需的测试。 在这个项目中，我们的目标是通过一个简短的、 计算机化测试程序。检查可以由护士或其他工作人员在临床上进行，费用 钱很少。我们将在诊断出白血病后不久开始对儿童进行测试，还有几个 在他们的治疗过程中，这样我们就可以尽快发现问题 开始发生了。我们研究中的儿童还将接受一小时的评估，广泛使用 由心理学家在确诊五年后进行的学习和记忆测试。我们会 确定计算机化测试的结果是否能够预测 由心理学家提供的更传统的测试。如果及早进行计算机化测试 治疗可以帮助我们更好地预测谁会继续有困难，我们可以帮助减缓 或者消除这些问题。 最后，我们想要确定其他因素在多大程度上也导致了 发展为白血病治疗的结果。我们特别感兴趣的是观察因素 已知会影响孩子的思维和学习技能，比如一个家庭获得资源的机会，精神上的 健康困难，以及在治疗过程中可能出现的医疗问题。我们还将要求 让孩子们在完成训练前告诉我们他们有多累、多病、多痛 计算机化测试程序。因为有一些证据表明这些类型的 症状可能会影响儿童在认知测试中的表现，我们认为 描述这些症状对儿童早期思维和学习的影响 治疗，也是在很久以后。如果我们能更好地理解所有这些因素是如何与 幸存者的思维和学习模式，我们可以更好地预测哪些人可能是 受这些问题的影响。