Department of Pediatrics, Japanese Red Cross Narita Hospital, 90-1 Iida-cho, Narita-shi, Chiba, 286-8523, Japan.
Department of Medical Oncology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8677, Japan.
BMC Pediatr. 2022 May 21;22(1):298. doi: 10.1186/s12887-022-03369-0.
Although treatment of acute myeloid leukemia (AML) contains neurotoxic agents, studies investigating neurocognitive outcomes in children with AML are sparse. We evaluated late cognitive effects in children treated with a high-dose cytarabine based regimen, focusing on general intellectual ability and specific neurocognitive domains.
We evaluated 12 survivors of childhood AML who were treated between 2006 and 2016 and completed the Wechsler Intelligence Scales. One-sample t-tests were used to compare full-scale intelligence quotient (FSIQ) and primary index scores to norms. The overall effect of index scores and subtests was examined with one-way ANOVA. Univariate analyses and multiple regression models examined demographic and clinical characteristics associated with FSIQ.
Participants who underwent the Wechsler Intelligence Scale for Children demonstrated impairment on working memory index and participants who underwent the Wechsler Adult Intelligence Scale showed low score in the subtests that reflect working memory, whereas they exhibited no statistical differences versus the population means for FSIQ. There were no significant differences in the overall effect of index scores and subtests. On univariate analysis, FSIQ were related to time since diagnosis and age at assessment, and both were significant predictors of FSIQ on multiple linear regression.
Survivors of childhood AML exhibited impairment of working memory, even if their FSIQ was within the normal range. Difficulties in specific cognitive domains are associated with reduced quality of life. It is important to identify survivors who are at risk and provide tailored interventions.
尽管急性髓系白血病（AML）的治疗包含神经毒性药物，但针对 AML 患儿神经认知结局的研究却很少。我们评估了接受高剂量阿糖胞苷为基础方案治疗的儿童的迟发性认知影响，重点关注总体智力和特定神经认知领域。
我们评估了 12 名在 2006 年至 2016 年期间接受治疗的儿童 AML 幸存者，他们完成了韦氏智力测验。单样本 t 检验用于将全量表智商（FSIQ）和主要指数得分与常模进行比较。使用单因素方差分析检查指数得分和子测验的总体效果。单变量分析和多元回归模型检查与 FSIQ 相关的人口统计学和临床特征。
接受韦氏儿童智力量表测试的参与者在工作记忆指数上表现出损伤，接受韦氏成人智力量表测试的参与者在反映工作记忆的子测验中得分较低，而与 FSIQ 的人群平均值相比，他们没有统计学差异。指数得分和子测验的总体效果没有显著差异。在单变量分析中，FSIQ 与诊断后时间和评估时年龄有关，且均为 FSIQ 的显著预测因子。
即使 AML 儿童的 FSIQ 在正常范围内，他们也表现出工作记忆受损。特定认知领域的困难与生活质量下降有关。识别处于危险中的幸存者并提供量身定制的干预措施非常重要。
