The impact of therapy for childhood acute lymphoblastic leukaemia on intelligence quotients; results of the risk-stratified randomized central nervous system treatment trial MRC UKALL XI
<p>Abstract</p> <p>Background</p> <p>The MRC UKALLXI trial tested the efficacy of different central nervous system (CNS) directed therapies in childhood acute lymphoblastic leukaemia (ALL). To evaluate morbidity 555/1826 randomised children underwent prospective psychol...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2011-10-01
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| Series: | Journal of Hematology & Oncology |
| Subjects: | |
| Online Access: | http://www.jhoonline.org/content/4/1/42 |
| _version_ | 1828301586789564416 |
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| author | Vargha-Khadem Faraneh Richards Sue Buck Georgina Halsey Christina Hill Frank Gibson Brenda |
| author_facet | Vargha-Khadem Faraneh Richards Sue Buck Georgina Halsey Christina Hill Frank Gibson Brenda |
| author_sort | Vargha-Khadem Faraneh |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>The MRC UKALLXI trial tested the efficacy of different central nervous system (CNS) directed therapies in childhood acute lymphoblastic leukaemia (ALL). To evaluate morbidity 555/1826 randomised children underwent prospective psychological evaluations. Full Scale, verbal and performance IQs were measured at 5 months, 3 years and 5 years. Scores were compared in; (1) all patients (n = 555) versus related controls (n = 311), (2) low-risk children (presenting white cell count (WCC) < 50 × 10<sup>9</sup>/l) randomised to intrathecal methotrexate (n = 197) versus intrathecal and high-dose intravenous methotrexate (HDM) (n = 202), and (3) high-risk children (WCC ≥ 50 × 10<sup>9</sup>/l, age ≥ 2 years) randomised to HDM (n = 79) versus cranial irradiation (n = 77).</p> <p>Results</p> <p>There were no significant differences in IQ scores between the treatment arms in either low- or high-risk groups. Despite similar scores at baseline, results at 3 and 5 years showed a significant reduction of between 3.6 and 7.3 points in all three IQ scores in all patient groups compared to controls (P < 0.002) with a higher proportion of children with IQs < 80 in the patient groups (13% vs. 5% at 3 years p = 0.003).</p> <p>Conclusion</p> <p>Children with ALL are at risk of CNS morbidity, regardless of the mode of CNS-directed therapy. Further work needs to identify individuals at high-risk of adverse CNS outcomes.</p> <p>Trial registration</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/ISRCTN16757172">ISRCTN16757172</a></p> |
| first_indexed | 2024-04-13T13:24:57Z |
| format | Article |
| id | doaj.art-68120d0a87354c30a4fe3a502960c7bb |
| institution | Directory Open Access Journal |
| issn | 1756-8722 |
| language | English |
| last_indexed | 2024-04-13T13:24:57Z |
| publishDate | 2011-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Hematology & Oncology |
| spelling | doaj.art-68120d0a87354c30a4fe3a502960c7bb2022-12-22T02:45:11ZengBMCJournal of Hematology & Oncology1756-87222011-10-01414210.1186/1756-8722-4-42The impact of therapy for childhood acute lymphoblastic leukaemia on intelligence quotients; results of the risk-stratified randomized central nervous system treatment trial MRC UKALL XIVargha-Khadem FaranehRichards SueBuck GeorginaHalsey ChristinaHill FrankGibson Brenda<p>Abstract</p> <p>Background</p> <p>The MRC UKALLXI trial tested the efficacy of different central nervous system (CNS) directed therapies in childhood acute lymphoblastic leukaemia (ALL). To evaluate morbidity 555/1826 randomised children underwent prospective psychological evaluations. Full Scale, verbal and performance IQs were measured at 5 months, 3 years and 5 years. Scores were compared in; (1) all patients (n = 555) versus related controls (n = 311), (2) low-risk children (presenting white cell count (WCC) < 50 × 10<sup>9</sup>/l) randomised to intrathecal methotrexate (n = 197) versus intrathecal and high-dose intravenous methotrexate (HDM) (n = 202), and (3) high-risk children (WCC ≥ 50 × 10<sup>9</sup>/l, age ≥ 2 years) randomised to HDM (n = 79) versus cranial irradiation (n = 77).</p> <p>Results</p> <p>There were no significant differences in IQ scores between the treatment arms in either low- or high-risk groups. Despite similar scores at baseline, results at 3 and 5 years showed a significant reduction of between 3.6 and 7.3 points in all three IQ scores in all patient groups compared to controls (P < 0.002) with a higher proportion of children with IQs < 80 in the patient groups (13% vs. 5% at 3 years p = 0.003).</p> <p>Conclusion</p> <p>Children with ALL are at risk of CNS morbidity, regardless of the mode of CNS-directed therapy. Further work needs to identify individuals at high-risk of adverse CNS outcomes.</p> <p>Trial registration</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/ISRCTN16757172">ISRCTN16757172</a></p>http://www.jhoonline.org/content/4/1/42acute lymphoblastic leukaemiaIQcentral nervous systemmorbiditycranial radiotherapymethotrexateneuropsychometricpaediatric |
| spellingShingle | Vargha-Khadem Faraneh Richards Sue Buck Georgina Halsey Christina Hill Frank Gibson Brenda The impact of therapy for childhood acute lymphoblastic leukaemia on intelligence quotients; results of the risk-stratified randomized central nervous system treatment trial MRC UKALL XI Journal of Hematology & Oncology acute lymphoblastic leukaemia IQ central nervous system morbidity cranial radiotherapy methotrexate neuropsychometric paediatric |
| title | The impact of therapy for childhood acute lymphoblastic leukaemia on intelligence quotients; results of the risk-stratified randomized central nervous system treatment trial MRC UKALL XI |
| title_full | The impact of therapy for childhood acute lymphoblastic leukaemia on intelligence quotients; results of the risk-stratified randomized central nervous system treatment trial MRC UKALL XI |
| title_fullStr | The impact of therapy for childhood acute lymphoblastic leukaemia on intelligence quotients; results of the risk-stratified randomized central nervous system treatment trial MRC UKALL XI |
| title_full_unstemmed | The impact of therapy for childhood acute lymphoblastic leukaemia on intelligence quotients; results of the risk-stratified randomized central nervous system treatment trial MRC UKALL XI |
| title_short | The impact of therapy for childhood acute lymphoblastic leukaemia on intelligence quotients; results of the risk-stratified randomized central nervous system treatment trial MRC UKALL XI |
| title_sort | impact of therapy for childhood acute lymphoblastic leukaemia on intelligence quotients results of the risk stratified randomized central nervous system treatment trial mrc ukall xi |
| topic | acute lymphoblastic leukaemia IQ central nervous system morbidity cranial radiotherapy methotrexate neuropsychometric paediatric |
| url | http://www.jhoonline.org/content/4/1/42 |
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