Kramer J H, Crittenden M R, DeSantes K, Cowan M J
University of California, San Francisco Medical Center 94143, USA.
Bone Marrow Transplant. 1997 Mar;19(6):607-13. doi: 10.1038/sj.bmt.1700699.
Children receiving a bone marrow transplant (BMT) are at risk for neuropsychological late effects because of potentially neurotoxic chemotherapy and total body irradiation. The goal of this study was to prospectively and longitudinally assess the intellectual and adaptive functioning of children receiving a BMT. This study examined 67 children whose development was evaluated at baseline prior to BMT and at 1 year follow-up. Mean age at BMT was 45 months. Repeated-measures ANOVA indicated a significant decline in IQ between baseline and the 1 year follow-up evaluation. Multivariate and exploratory univariate analyses examined the potential influence of diagnosis, treatment regimen, cranial radiation dose, age at time of transplant, and sex of child but none of these independent variables predicted outcome. Twenty-six children (mean age at BMT of 28.4 months) were also given developmental evaluations 3 years post-BMT. Although IQ at the 1 year follow-up was significantly lower than baseline, no further changes were evident at the 3 year follow-up evaluation. Scores on the Vineland Adaptive Behavior Scales also dropped significantly between baseline and the 1 year follow-up, but did not change between the 1 year and 3 year evaluations.
由于潜在的神经毒性化疗和全身照射，接受骨髓移植（BMT）的儿童存在神经心理远期效应的风险。本研究的目的是对接受BMT的儿童的智力和适应性功能进行前瞻性和纵向评估。本研究考察了67名儿童，他们在BMT前的基线期和随访1年时接受了发育评估。BMT时的平均年龄为45个月。重复测量方差分析表明，基线期和随访1年评估之间智商有显著下降。多变量和探索性单变量分析考察了诊断、治疗方案、颅辐射剂量、移植时年龄和儿童性别等潜在影响因素，但这些自变量均未预测出结果。26名儿童（BMT时的平均年龄为28.4个月）在BMT后3年也接受了发育评估。虽然随访1年时的智商显著低于基线期，但在随访3年评估时没有明显进一步变化。文兰适应行为量表的得分在基线期和随访1年之间也显著下降，但在随访1年和3年评估之间没有变化。
