Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.
Department of Psychology, University of Oslo, Oslo, Norway.
J Int Neuropsychol Soc. 2024 Jul;30(6):523-532. doi: 10.1017/S1355617724000080. Epub 2024 Mar 11.
There is limited research on neurocognitive outcome and associated risk factors in long-term, adult survivors of childhood acute lymphoblastic leukemia (ALL), without treatment of cranial radiation therapy. Moreover, the impact of fatigue severity and pain interference on neurocognition has received little attention. In this cross-sectional study, we examined neurocognitive outcome and associated factors in this population.
Intellectual abilities, verbal learning/memory, processing speed, attention, and executive functions were compared to normative means/medians with one sample tests or Wilcoxon signed-rank tests. Associations with risk factors, fatigue severity, and pain interference were analyzed with linear regressions.
Long-term, adult survivors of childhood ALL ( = 53, 51% females, mean age = 24.4 years, = 4.4, mean = 14.7 years post-diagnosis, = 3.4) demonstrated above average intellectual abilities, but performed below average in attention, inhibition, processing speed, and shifting ( < 0.001). Executive functioning complaints were significantly higher than normative means, and positively associated with fatigue ( < 0.001). There was no interaction between sex and fatigue and no neurocognitive impairments were associated with pain interference, risk group, age at diagnosis, or sex.
Long-term, adult survivors of ALL treated without cranial radiation therapy, demonstrate domain-specific performance-based neurocognitive impairments. However, continued research on the neurocognitive outcome in this population as they age will be important in the coming years. Executive functioning complaints were frequently in the clinical range, and often accompanied by fatigue. This suggests a need for cognitive rehabilitation programs.
在没有颅放射治疗的情况下，对长期、成年的儿童急性淋巴细胞白血病（ALL）幸存者的神经认知结果和相关风险因素进行研究还很有限。此外，疲劳严重程度和疼痛干扰对神经认知的影响也很少受到关注。在这项横断面研究中，我们研究了该人群的神经认知结果和相关因素。
使用单一样本 t 检验或 Wilcoxon 符号秩检验，将智力能力、言语学习/记忆、处理速度、注意力和执行功能与正常均值/中位数进行比较。使用线性回归分析与风险因素、疲劳严重程度和疼痛干扰的关联。
儿童 ALL 长期成年幸存者（n=53，女性占 51%，平均年龄 24.4 岁，诊断后平均 4.4 年，平均年龄 14.7 岁，n=3.4）表现出高于平均水平的智力能力，但在注意力、抑制、处理速度和转换方面表现出低于平均水平（<0.001）。执行功能的抱怨明显高于正常水平，且与疲劳呈正相关（<0.001）。性别与疲劳之间没有交互作用，疼痛干扰、风险组、诊断时年龄或性别与任何神经认知损伤均无关。
未接受颅放射治疗的 ALL 长期成年幸存者表现出特定领域的基于表现的神经认知损伤。然而，在未来几年，对该人群的神经认知结果进行研究将非常重要。执行功能的抱怨经常处于临床范围，并且常常伴有疲劳。这表明需要认知康复计划。
