Cognitive Impairment in Survivors of Pediatric Acute Lymphoblastic Leukemia Treated With Chemotherapy Only
Authors: Ellen van der Plas, Arunkumar J. Modi, Chi Kong Li, Kevin R. Krull, Yin Ting Cheung
Journal: Journal of Clinical Oncology (2021)

Article Tools REVIEW ARTICLES Neurocognitive Outcomes in Survivors of Pediatric Cancer Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.20.02322 Journal of Clinical Oncology - published online before print April 22, 2021 PMID: 33886368 Cognitive Impairment in Survivors of Pediatric Acute Lymphoblastic Leukemia Treated With Chemotherapy Only Ellen van der Plas , PhD1xEllen van der PlasSearch for articles by this author; Arunkumar J. Modi, MBBS, MPH2xArunkumar J. ModiSearch for articles by this author; Chi Kong Li , MBBS, MD3,4,5xChi Kong LiSearch for articles by this author; Kevin R. Krull , PhD6,7xKevin R. KrullSearch for articles by this author; and Yin Ting Cheung , PhD8xYin Ting CheungSearch for articles by this author Show More 1Department of Psychiatry, University of Iowa Hospital & Clinics, Iowa, IA2Stead Family Department of Pediatrics, University of Iowa, Iowa, IA3Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China4Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China5Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong SAR, China6Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN7Department of Psychology, St Jude Children's Research Hospital, Memphis, TN8School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China https://doi.org/10.1200/JCO.20.02322 First Page Full Text PDF Figures and Tables © 2021 by American Society of Clinical OncologyCONTEXTKey ObjectiveThe goal of this review is to provide an up-to-date summary of current evidence regarding neurocognitive outcomes in survivors of pediatric acute lymphoblastic leukemia treated with chemotherapy only. Limitations and controversies are highlighted, and directions for future research are discussed.Knowledge GeneratedImpairments in attention, fine motor skill, processing speed, mathematics, and executive functions have consistently been identified in survivors of pediatric acute lymphoblastic leukemia. Risk factors of neurocognitive impairment can broadly be categorized into demographic (eg, young age at diagnosis), treatment characteristics (eg, exposure to high-dose methotrexate), genetic modulators (eg, polymorphism folate pathway genes), and physical complications during treatment (eg, sepsis).RelevanceThe field is now poised to identify mechanisms of neurocognitive deficits, which is necessary in the development of targeted strategies of mitigation, remediation, and prevention. Using data from large, multinational, longitudinal studies may help develop prediction models for this complex phenotype.SUPPORTSupported in part by the Hong Kong Research Grant Council (ref no: 24614818) awarded to Y.T.C.AUTHOR CONTRIBUTIONSConception and design: Ellen van der Plas, Arunkumar J. Modi, Chi Kong Li, Kevin R. Krull, Yin Ting CheungFinancial support: Yin Ting CheungCollection and assembly of data: Ellen van der Plas, Chi Kong Li, Yin Ting CheungData analysis and interpretation: Ellen van der Plas, Arunkumar J. Modi, Chi Kong Li, Yin Ting CheungManuscript writing: All authorsFinal approval of manuscript: All authorsAccountable for all aspects of the work: All authorsAUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTERESTCognitive Impairment in Survivors of Pediatric Acute Lymphoblastic Leukemia Treated With Chemotherapy OnlyThe following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated unless otherwise noted. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO’s conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/authors/author-center.Open Payments is a public database containing information reported by companies about payments made to US-licensed physicians (Open Payments).Chi Kong LiConsulting or Advisory Role: Amgen AsiaKevin R. KrullPatents, Royalties, Other Intellectual Property: Royalties from Wolters KluwerNo other potential conflicts of interest were reported.