Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Eur J Haematol. 2024 Feb;112(2):266-275. doi: 10.1111/ejh.14112. Epub 2023 Oct 5.
This study examines associations of functional outcomes (adaptive functioning and academic achievement) with executive functioning (EF), socioeconomic status (SES), and academic support in pediatric acute lymphoblastic leukemia (ALL) survivors.
Fifty survivors of B-lineage ALL treated with chemotherapy-only (42% female, 76% NHW, ages 6-19) were evaluated on performance-based EF and academic achievement, and parent-rated EF and adaptive functioning. Area deprivation and child opportunity (i.e., SES) were extracted using census blocks and tracts. Academic support data were extracted from chart review.
Compared to population norms, pediatric ALL survivors demonstrated significantly lower overall adaptive skills and performance in word reading and math calculation (all p ≤ .011). Frequencies of impairment were significantly elevated on all adaptive scales and in math calculation compared to the population (all p ≤ .002). Parent-rated EF significantly predicted overall adaptive skills (p < .001), while performance-based EF significantly predicted word reading and math calculation (all p < .05). Adaptive functioning was not associated with neighborhood-specific variables or academic support. However, academic support predicted word reading (p < .001), while area deprivation and academic support predicted performance-based EF (all p ≤ .02).
Screening of functional outcomes, targeted intervention, and neuropsychological monitoring are necessary to support pediatric ALL survivors' neurocognitive and psychosocial development.
本研究探讨了功能结果（适应功能和学业成就）与执行功能（EF）、社会经济地位（SES）和儿科急性淋巴细胞白血病（ALL）幸存者的学业支持之间的关联。
对接受单纯化疗的 B 系 ALL 幸存者 50 例（女性占 42%，非西班牙裔白人占 76%，年龄 6-19 岁）进行基于表现的 EF 和学业成就评估，以及家长评定的 EF 和适应功能评估。使用人口普查块和地段提取区域剥夺和儿童机会（即 SES）。从图表审查中提取学业支持数据。
与人群正常值相比，儿科 ALL 幸存者在总体适应技能和阅读文字和数学计算方面的表现明显较低（均 p≤0.011）。在所有适应性量表和数学计算方面，损伤频率明显高于人群（均 p≤0.002）。家长评定的 EF 显著预测总体适应技能（p<0.001），而基于表现的 EF 显著预测阅读文字和数学计算（均 p<0.05）。适应性功能与特定于邻里的变量或学业支持无关。然而，学业支持预测阅读文字（p<0.001），而区域剥夺和学业支持预测基于表现的 EF（均 p≤0.02）。
对功能结果进行筛查、针对性干预和神经心理学监测对于支持儿科 ALL 幸存者的神经认知和心理社会发展是必要的。
