A-262 Cognitive and Occupational Status of Young Adult Survivors of Leukemia/Lymphoma Prior to Transition to Adult-Centered Care

• Published in: Archives of clinical neuropsychology 2022-08, Vol.37 (6), p.1411-1411
• Main Authors: Balderrama, Melissa, Whitaker, Ashley M, Mendoza, Leanne
• Format: Article
• Language: English
• ISSN: 1873-5843; 1873-5843
• DOI: 10.1093/arclin/acac060.262

Abstract Objective: Treatment for pediatric acute lymphoblastic leukemia/non-Hodgkin’s lymphoma (ALL/NHL) confers risk of long-term cognitive sequelae, though many survivors lose access to neuropsychological monitoring once they transition to adult-centered care. The objective of this study is to describe the frequency/severity of cognitive concerns of ALL/NHL survivors who are about to transition care in relation to occupational status and school service utilization. Method: Thirty-eight young adult (x ̅=19.5 years), primarily Latino, survivors of ALL/NHL underwent neuropsychological evaluation. Domains included working memory (Wechsler Adult Intelligence Scale–Fourth Edition [WAIS-IV] Digit Span [DS]), processing speed (Symbol Digit Modalities Test [SDMT]/WAIS-IV Coding), and sustained attention (Conners Continuous Performance Test–Third Edition [CPT-3]). Occupational status was determined during interview. Results: Survivors exhibited lower working memory (z=-4.44, p=.00001) and processing speed (SDMT z=-3.82, p=.00014; CPT-3 Hit Reaction Time z=2.57, p=.01) compared to normative expectations. Nearly 90% of the sample was in school and/or working at the time of evaluation. Of those attending higher education (74%), over 35% performed at least one standard deviation below the mean across DS and SDMT/Coding (which is over twice as frequent as in the normative population), though less than 15% were receiving accommodations. Conclusion: Despite increased risk of working memory and processing speed deficits, the majority of our sample was in school and/or working at the time of evaluation. While this confirms the resiliency of young adult survivors, their need for supportive services that address cognitive barriers may be under-recognized. Neuropsychological monitoring in this age group remains critical to create avenues for support during the transition to adult-centered care.