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Assessment of Executive Functions after Treatment of Childhood Acute Lymphoid Leukemia: a Systematic Review

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Abstract

Individuals treated for childhood acute lymphoblastic leukemia (ALL) have a high survival rate. This fact, however, may lead to neurocognitive impairments in survivors, as shown in some studies. The prefrontal cortex and executive functions seem to be particularly vulnerable due to the late maturation in the development process. Executive impairments have been associated with poorer quality of life in childhood cancer survivors. A systematic review was carried out with studies that assessed executive functions in childhood ALL survivors.\ Studies were collected from five electronic databases: MEDLINE (PubMed); PsycInfo; WebOfScience; LILACS and IBECS. Eighty-four studies were retrieved from the database search, of which 50 were read in full and 26 met the inclusion criteria. The studies were heterogeneous as to the instruments used to assess executive function, the skills assessed and the comparison methods. Despite some discrepancies, ALL survivors seem to exhibit poorer executive functioning than typical controls, but this result did not hold true when subjects were compared to normative mean. Changes in brain structure and dynamics resulting from the disease itself, the toxicity of the treatment and difficulties in coping with the stress during treatment may be related to executive impairments in ALL survivors. Discussion proposed standardized methods and measures for assessing executive functioning in children during and after ALL treatment.

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Acknowledgements

This study was supported by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) and by Associação Fundo de Incentivo à Pesquisa (AFIP). Priscilla Brandi Gomes Godoy is the recipient of a Masters in Science fellowship from FAPESP (grant # 2017/04483-7). Deborah Suchecki is the recipient of a Research Fellowship from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, grant # 303449/2015-2). The funding agencies had no role in experimental design, preparation, review or approval of this study.

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  1. Departamento de Psicobiologia, Universidade Federal de São Paulo, UNIFESP, Rua Napoleão de Barros, 925 – Vila Clementino, São Paulo, SP, 04023062, Brazil

    Priscilla Brandi Gomes Godoy, Natalia Maria Simionato, Claudia Berlim de Mello & Deborah Suchecki

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Godoy, P.B.G., Simionato, N.M., de Mello, C.B. et al. Assessment of Executive Functions after Treatment of Childhood Acute Lymphoid Leukemia: a Systematic Review. Neuropsychol Rev 30, 386–406 (2020). https://doi.org/10.1007/s11065-020-09446-4

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