Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105-3678, USA.
Blood. 2013 Jul 25;122(4):550-3. doi: 10.1182/blood-2013-03-487744. Epub 2013 Jun 6.
Survivors of childhood acute lymphoblastic leukemia (ALL) treated with cranial radiation therapy (CRT) are at risk for cognitive impairment, although whether impairment progresses with age into adulthood is unknown. We report change in intelligence for 102 adult survivors of childhood ALL (age range, 26.6-54.7 years) during a median interval of 28.5 years. Survivors demonstrated lower Performance intelligence (mean, 95.3; standard deviation, 16.5; P = .005) but not Verbal IQ (mean, 97.4; standard deviation, 15.44; P = .09) at initial testing. Verbal intelligence declined an average of 10.3 points (P < .0001) during the follow-up interval with no decline in Performance intelligence. Decline was associated with current attention problems (P = .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. This trial was registered at clinicaltrials.gov as no. NCT00760656.
接受颅部放射治疗（CRT）的儿童急性淋巴细胞白血病（ALL）幸存者存在认知障碍的风险，尽管其认知损害是否会随着年龄增长而进展到成年期尚不清楚。我们报告了 102 名儿童 ALL 成年幸存者（年龄范围为 26.6-54.7 岁）在中位数为 28.5 年的随访期间智力的变化。在初次测试中，幸存者的表现智力（均值为 95.3，标准差为 16.5，P=0.005）较低，但言语智商（均值为 97.4，标准差为 15.44，P=0.09）没有降低。在随访期间，言语智力平均下降了 10.3 分（P<0.0001），而表现智力没有下降。下降与当前的注意力问题有关（P=0.002），但与性别、CRT 剂量、CRT 暴露时的年龄或两次测试之间的时间无关。结果表明，接受 CRT 治疗的儿童 ALL 长期幸存者存在言语智力进行性下降的风险，这可能是由注意力缺陷引起的。该试验在 clinicaltrials.gov 上注册为 NCT00760656。
