Neuropsychological and neurological outcome after relapse of lymphoblastic leukaemia

Fourteen children who relapsed after initial remission of leukaemia were studied. Six received a second course of cranial radiotherapy, while the remaining eight children were given total body irradiation before bone marrow transplantation. The postirradiation somnolence syndrome was common after cr...

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Bibliographic Details
Published in:Archives of disease in childhood 1994-04, Vol.70 (4), p.275-280
Main Authors: Christie, D, Battin, M, Leiper, A D, Chessells, J, Vargha-Khadem, F, Neville, B G
Format: Article
Language:English
Subjects:
Age Factors
Biological and medical sciences
Bone marrow
Bone marrow transplantation
Brain - pathology
Cataracts
Child
Child, Preschool
Children
Cognition Disorders - etiology
Cranial Irradiation
Developmental Disabilities - etiology
Education
Female
Growth Disorders - etiology
Growth hormones
Hematologic and hematopoietic diseases
Humans
Infant
Intelligence
Irradiation
Leukemia
Leukemia, Lymphoid - pathology
Leukemia, Lymphoid - radiotherapy
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Leukemic Infiltration - radiotherapy
Male
Medical sciences
Methotrexate - adverse effects
Morbidity
Nervous System Diseases - etiology
Neuropsychology
Pediatrics
Radiation Injuries - etiology
Radiation therapy
Radiotherapy - adverse effects
Recurrence
Remission
Skull
Whole-Body Irradiation
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Summary:Fourteen children who relapsed after initial remission of leukaemia were studied. Six received a second course of cranial radiotherapy, while the remaining eight children were given total body irradiation before bone marrow transplantation. The postirradiation somnolence syndrome was common after cranial radiotherapy. All children had mild/soft neurological signs, mostly of coordination. None had a major motor disability. All but the youngest child had cataracts; two children required an operation for these. All children were growth hormone deficient. Verbal IQ, attention, and concentration were selectively reduced (with respect to normative levels). The time between the two treatments, age at relapse, and higher doses of radiotherapy all correlated with cognitive outcome, with girls showing greater impairments than boys. Only two children were performing at age appropriate levels on measures of academic achievement. It is concluded that neurological and neuropsychological morbidity is significantly increased by the current treatments prescribed after the relapse of leukaemia.
ISSN:0003-9888
1468-2044
DOI:10.1136/adc.70.4.275