Long-term decline in intelligence among adult survivors of childhood acute lymphoblastic leukemia treated with cranial radiation
Mené sur 102 patients ayant reçu une radiothérapie crânienne durant l'enfance pour traiter une leucémie lymphoblastique aiguë (âge moyen : 38,5 ans ; durée médiane de l'intervalle de suivi : 28,5 ans), cet essai montre une diminution à long terme des capacités cognitives des patients à l'âge adulte
Survivors of childhood acute lymphoblastic leukemia (ALL) treated with cranial radiation therapy (CRT) are at risk for cognitive impairment, though whether impairment progresses with age into adulthood is unknown. We report change in intelligence for 102 adult survivors of childhood ALL (mean age at follow-up = 38.5 years, range 26.6-54.7 years), over a median interval of 28.5 years. Compared to age-specific national norms, survivors demonstrated lower Performance intelligence (mean=95.3, SD=16.5; p=0.005), but not Verbal IQ (97.4 [15.44]; p=0.09) at initial testing. Verbal intelligence declined an average of 10.3 points (p<0.0001) over the follow-up interval with no decline in Performance intelligence. This decline was associated with current attention problems, (p=0.002), but not gender, CRT dose, age at CRT exposure, or years between testing. Results suggest long-term survivors of childhood ALL treated with CRT are at risk for progressive decline in verbal intellect, which may be driven by attention deficits. (ClinicalTrials.gov Identifier: NCT00760656)