Departments of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.
Pediatr Blood Cancer. 2020 Mar;67(3):e27968. doi: 10.1002/pbc.27968. Epub 2019 Aug 12.
Survivors of childhood acute lymphoblastic leukemia (ALL) treated with chemotherapy only are at risk for neurocognitive impairment. Regions of interest were identified a priori based on glucocorticoid receptor distribution, and sex-stratified multivariable linear regression models were used to test associations between brain MRI morphology and total number of intrathecal injections, and serum concentration of dexamethasone and methotrexate. Compared with controls, ALL survivors have persistently smaller volumes in the bilateral cerebellum (P < 0.005), hippocampal subregions (P < 0.03), temporal lobe regions (P < 0.03), frontal lobe regions (P < 0.04), and parietal lobe regions (precuneus; P < 0.002). Long-term problems with learning may be related to residual posttreatment brain differences.
仅接受化疗治疗的儿童急性淋巴细胞白血病 (ALL) 幸存者存在神经认知障碍的风险。根据糖皮质激素受体分布，预先确定了感兴趣区域，并且使用按性别分层的多变量线性回归模型来测试脑 MRI 形态与鞘内注射总数以及地塞米松和甲氨蝶呤的血清浓度之间的关联。与对照组相比，ALL 幸存者的双侧小脑（P < 0.005）、海马亚区（P < 0.03）、颞叶区域（P < 0.03）、额叶区域（P < 0.04）和顶叶区域（楔前叶；P < 0.002）的体积持续较小。学习方面的长期问题可能与治疗后残留的大脑差异有关。
