B - 09 Neuropsychological Impacts and Cognitive Effects of Pediatric Leukemia Treatment.

Abstract

The current study seeks to investigate the neuropsychological and cognitive late effects of pediatric Acute Lymphoblastic Leukemia (ALL) treatment. A search for peer-reviewed articles was conducted. Google Scholar was searched using keywords including neuropsychology, neuro-cognitive, neuropsychological effects, neuropsychological battery, neuropsychological impacts, cognitive effects, cognitive impacts, pediatric, pediatric leukemia, acute lymphoblastic leukemia treatment, bone marrow transplant, whole brain radiation, whole-body radiation, chemotherapy, cranial radiotherapy, health psychology, and neuropsychological testing. Articles were included if they discussed neuropsychology and ALL. Articles with non-human subjects and case studies were excluded from the study. Fifty-nine studies were included in the study. Treatments for ALL result in impairments in working memory, reduced processing speed, attention deficits, executive functioning deficits, visual-spatial and visuomotor weakness, fine motor weakness, deficits in delayed memory, an initial decline in performance IQ, and a delayed decline in verbal abilities such as attention and reading. The initial decline in performance abilities following a late decline in verbal abilities seen in patients who have undergone CRT may be due to structural changes in the white and gray matter following CRT treatment. Healthcare providers should attend to patients' cognitive complaints, particularly as they pertain to patients' ability to adhere to treatment recommendations and subsequently to their ability to resume attending school or social roles. As patient and parent complaints of cognitive compromise are associated with psychological distress and functional decline, cognitive complaints could justify further in-depth neuropsychological assessment to mobilize comprehensive supportive care or rehabilitative services.