Pediatric Cancer Survivors: Neurocognitive Late Effects

  • Sarah Hile
  • Erica Montague
  • Bonnie Carlson-Green
  • Paul Colte
  • Leanne Embry
  • Robert D. Annett
Chapter
Part of the Pediatric Cancer book series (PECA, volume 2)

Abstract

Neurocognitive deficits are a common late effect experienced by pediatric cancer survivors and can manifest across a variety of domains including: attention and concentration, executive functioning, processing speed, psychomotor skills, verbal memory, visuospatial skills, and language (Moore J, Pediatr Psychol 30:51–63, 2005). Deficits have also been found to manifest across the broader domains of global intellectual functioning and academic performance. These deficits, however, seem to be limited to the specific diagnoses of leukemia and brain tumors. This is largely due to the aggressive CNS-directed treatments, as they induce inalterable structural damage to the brain, which has been linked back to observable deficits in neurocognitive functioning. Preliminary research also indicates that neurocognitive deficits can have serious implications for survivors’ overall functional capabilities as well as their general quality of life. As such, a variety of interventions have begun to be developed in order to address these issues. However, research surrounding these two areas is still in its infancy. Future research needs to address how neurocognitive late effects interfere with greater functional capabilities and general quality of life as well as how interventions can help combat these problems.

Keywords

Cancer Survivor Acute Lymphoblastic Leukemia Cranial Radiation Therapy Childhood Cancer Survivor Pediatric Brain Tumor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Anderson DM, Rennie KM, Ziegler RS, Neglla JP, Robison LR, Gurney JG (2001) Medical and neurocognitive late effects among survivors of childhood central nervous system tumors. Cancer 92:2709–2719PubMedCrossRefGoogle Scholar
  2. Askins M, Moore B (2008) Preventing neurocognitive late effects in childhood cancer survivors. J Child Neurol 23:1160–1171PubMedCrossRefGoogle Scholar
  3. Askins MA, Sahler OJ, Sherman SA, Fairclough DL, Butler RW, Katz ER, Dolgin MJ, Varni JW, Noll RB, Phipps S (2009) Report from a multi-institutional randomized clinical trial examining computer-assisted problem-solving skills training for English- and Spanish-speaking mothers of children with newly diagnosed cancer. J Pediatr Psychol 34:551–563PubMedCrossRefGoogle Scholar
  4. Ater JL, van Eys J, Woo SY, Copeland DR, Bruner J (1997) MOPP chemotherapy without irradiation as a primary postsurgical therapy for brain tumors in infants and young children. J Neurooncol 32:243–252PubMedCrossRefGoogle Scholar
  5. Buizer AI, de Sonneville LM, van den Heuvel-Eibrink MM, Veerman AJ (2006) Behavioral and educational limitations after chemotherapy for childhood acute lymphoblastic leukemia or Wilms tumor. Cancer 106:2067–2074PubMedCrossRefGoogle Scholar
  6. Buizer AI, de Sonneville LM, Veerman AJ (2009) Effects of chemotherapy on neurocognitive function in children with acute lymphoblastic leukemia: a critical review of the literature. Pediatr Blood Cancer 52:447–454PubMedCrossRefGoogle Scholar
  7. Butler R, Copeland D, Fairclough D, Mulhern R, Katz E, Kazak A, Noll RB, Patel SK, Sahler OJ (2008) A multicenter, randomized clinical trial of a cognitive remediation program for childhood survivors of a pediatric malignancy. J Consult Clin Psychol 76:367–378PubMedCrossRefGoogle Scholar
  8. Campbell LK, Scaduto M, Sharp W, Dufton L, Van Slyke D, Whitlock JA, Compas B (2007) A meta-analysis of the neurocognitive sequelae of treatment for childhood acute lymphocytic leukemia. Pediatr Blood Cancer 49:65–73PubMedCrossRefGoogle Scholar
  9. Carlson-Green B (2009) Brain tumor survivors speak out. J Pediatr Oncol Nurs 26:266–279PubMedCrossRefGoogle Scholar
  10. Carlson-Green B, Morris R, Krawiecki N (1995) Family and illness predictors of outcome in pediatric brain tumors. J Pediatr Psychol 20:769–784PubMedCrossRefGoogle Scholar
  11. Carpentieri SC, Waber DP, Pomeroy SL, Scot RM, Goumnerova LC, Kieran MW, Billett AL, Tarbell NJ (2003) Neuropsychological functioning after surgery in children treated for brain tumor. Neurosurgery 52:1348–1356PubMedCrossRefGoogle Scholar
  12. Conklin HM, Helton S, Ashford J, Mulhern RK, Reddick WE, Bonner M, Japer BW, Wu S, Xiong X, Khan RB (2010) Predicting methylphenidate response in long-term survivors of childhood cancer: a randomized, double-blind, placebo-controlled. J Pediatr Psychol 35(2):144–155PubMedCrossRefGoogle Scholar
  13. Ellenberg L, Liu Q, Gioia G, Yasui Y, Packer RJ, Mertens A, Donaldson SS, Stovall M, Kadan-Lottick N, Armstrong G, Robison LL, Zeltzer LK (2009) Neurocognitive status in long-term survivors of childhood CNS malignancies: a report from the childhood cancer survivor study. Neuropsychology 23:705–717PubMedCrossRefGoogle Scholar
  14. Hardy KK, Willard VW, Bonner MJ (2011) Computerized cognitive training in survivors of childhood cancer: a pilot study. J Pediatr Oncol Nurs 28(1):27–33PubMedCrossRefGoogle Scholar
  15. Institute of Medicine (2003) Childhood cancer survivorship: improving care and quality of life. The National Academies Press, Washington, DCGoogle Scholar
  16. Iuvone L, Mariotti P, Colosimo C, Guzzetta G, Ruggiero A, Riccardi R (2002) Long-term cognitive outcome, brain computed tomography scan, and magnetic resonance imaging in children cured for acute lymphoblastic leukemia. Cancer 95:2562–2570PubMedCrossRefGoogle Scholar
  17. Kadan-Lottick NS, Brouwers P, Breiger D, Kaleita T, Dziura J, Liu H, Chen L, Nicoletti M, Stork L, Bostrom B, Neglia JP (2009) A comparison of neurocognitive functioning in children previously randomized to dexamethasone or prednisone in the treatment of childhood acute lymphoblastic leukemia. Blood 114:1746–1752PubMedCrossRefGoogle Scholar
  18. Kazak AE, Alderfer MA, Rodriguez AM (2009) Psychosocial and behavioral issues in cancer survival in pediatric populations. In: Miller SM, Bowen DJ, Croyle RT, Rowland JH (eds) Handbook of cancer control and behavioral science: a resource for researchers, practitioners, and policymakers. American Psychological Association, Washington, DC, pp 449–465Google Scholar
  19. Krajinovic M, Robaey P, Chiasson S, Lemieux-Blanchard E, Rouillard M, Primeau M, Bournissen FG, Moghrabi A (2005) Polymorphisms of genes controlling homocysteine levels and IQ score following the treatment for childhood ALL. Pharmacogenomics 6:293–302PubMedCrossRefGoogle Scholar
  20. Krull KR, Huang S, Gurney JG, Klosky JL, Leisenring W, Termuhlen A, Ness KK, Kumar Srivastava D, Mertens A, Stovall M, Robison LL, Hudson MM (2010) Adolescent behavior and adult health status in childhood cancer survivors. J Cancer Surviv 4:210–217PubMedCrossRefGoogle Scholar
  21. Merchant TE (2009) Proton beam therapy in pediatric oncology. Cancer J 15:298–305PubMedCrossRefGoogle Scholar
  22. Mitby PA, Robinson LL, Whitton JA, Zevon MA, Gibs IC, Tersak JM, Meadows AT, Stovall M, Zeltzer LK, Mertens AC, and Childhood Cancer Survivor Study Steering Committee (2003) Utilization of special education services and educational attainment among long-term survivors of childhood cancer. Cancer 97:115–1126CrossRefGoogle Scholar
  23. Moleski M (2000) Neuropsychological, neuroanatomical, and neurophysiologic consequences of CNS chemotherapy for acute lymphoblastic leukemia. Arch Clin Neuropsychol 15:603–630PubMedGoogle Scholar
  24. Montour-Proulx I, Kuehn SM, Keene DL, Barrowman NJ, Hsu E, Matzinger M, Dunlap H, Halton JM (2005) Cognitive changes in children treated for acute lymphoblastic leukemia with chemotherapy only according to the Pediatric Oncology Group 9605 protocol. J Child Neurol 20:129–133PubMedCrossRefGoogle Scholar
  25. Moore BD 3rd (2005) Neurocognitive outcomes in survivors of childhood cancer. J Pediatr Psychol 30:51–63PubMedCrossRefGoogle Scholar
  26. Mulhern RK, Butler RW (2004) Neurocognitive sequelae of childhood cancers and their treatment. Pediatr Rehabil 7:1–14PubMedGoogle Scholar
  27. Nathan PC, Patel SK, Dilley K, Goldsby R, Harvey J, Jacobsen C, Kadan-Lottick N, McKinley K, Millham AK, Moore I, Okcu F, Woodman CL, Brouwers P, Armstrong FD (2007) Guidelines for identification of, advocacy for, and intervention in neurocognitive problems in survivors of childhood cancer: a report from the Children’s Oncology Group. Arch Pediatr Adolesc Med 161:798–806PubMedCrossRefGoogle Scholar
  28. Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, Friedman DL, Marina N, Hobbie W, Kadan-Lottick NS, Schwartz CL, Leisenring W, Robison LL (2006) Chronic health conditions in adult survivors of childhood cancer. N Engl J Med 355:1572–1582PubMedCrossRefGoogle Scholar
  29. Pang JWY, Friedman DL, Whitton JA, Stovall M, Mertens AC, Robison LL, Weiss NS (2008) Employment status among adult survivors in the childhood cancer survivor study. Pediatr Blood Cancer 50:104–110PubMedCrossRefGoogle Scholar
  30. Prevatt FF, Heffer RW, Lowe PA (2000) A review of school reintegration programs for children with cancer. J Sch Psychol 38:447–467CrossRefGoogle Scholar
  31. Reddick WE, White HA, Glass JO, Wheeler GC, Thompson SJ, Gajjar A, Leigh L, Mulhern RK (2003) Developmental model relating white matter volume to neurocognitive deficits in pediatric brain tumor survivors. Cancer 97:2512–2519PubMedCrossRefGoogle Scholar
  32. Reddick WE, Shan ZY, Glass JO, Helton S, Xlong X, Wu S, Bonner MJ, Howard SC, Christensen R, Khan RB, Pui C, Mulhern RK (2006) Smaller white-matter volumes are associated with larger deficits in attention and learning among long-term survivors of acute lymphoblastic leukemia. Cancer 106:941–949PubMedCrossRefGoogle Scholar
  33. Ris MD, Ryan PM, Lamba M, Brenemen J, Cecil K, Succop P, Ball W (2005) An improved methodology for modeling neurobehavioral late-effects of radiotherapy in pediatric brain tumors. Pediatr Blood Cancer 44:487–493PubMedCrossRefGoogle Scholar
  34. Robinson KE, Kuttesch JF, Champion JE, Andreotti CF, Hipp DW, Bettis A, Barnwell A, Compas BE (2010) A quantitative meta-analysis of neurocognitive sequelae in survivors of pediatric brain tumors. Pediatr Blood Cancer 55:525–531PubMedCrossRefGoogle Scholar
  35. Sands SA, Kellie SJ, Davidow AL, Diez B, Villablance J, Weiner HL, Pietanza MC, Balmaceda C, Finlay JL (2001) Long-term quality of life and neuropsychologic functioning for patients with CNS germ-cell tumors: from the First International CNS Germ-Cell Tumor Study. Neuro Oncol 3:174–183PubMedGoogle Scholar
  36. Schatz J, Kramer JH, Ablin A, Matthay KK (2000) Processing speed, working memory, and IQ: a developmental model of cognitive deficits following cranial radiation therapy. Neuropsychology 14:189–200PubMedCrossRefGoogle Scholar
  37. SEER (2007) Surveillance, Epidemiology, and End Results (SEER) program public-use data (1973-2004). National Cancer Institute, DCCPS, surveillance research program, cancer statistics branch, released April 2007. www.seer.cancer.gov/
  38. Strauss E, Sherman EMS, Spreen O (2006) A compendium of neuropsychological tests, 3rd edn. Oxford University Press, New YorkGoogle Scholar
  39. Waber DP, Carpentieri SC, Klar N, Silverman LB, Schwenn M, Hurwitz CA, Mullenix PJ, Tarbell NJ, Sallan SE (2000) Cognitive sequelae in children treated for acute lymphoblastic leukemia with dexamethasone or prednisone. J Pediatr Hematol Oncol 22:206–213PubMedCrossRefGoogle Scholar
  40. Zebrack BJ, Zeltzer LK, Whitton J, Mertens AC, Odom L, Berkow R, Robison LL (2004) Psychological outcomes in long-term survivors of childhood leukemia, hodgkin’s disease, and non-hodgkin’s lymphoma: a report from the Childhood Cancer Survivor Study. Pediatrics 110:42–52CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  • Sarah Hile
    • 1
  • Erica Montague
    • 1
  • Bonnie Carlson-Green
    • 2
  • Paul Colte
    • 3
  • Leanne Embry
    • 4
  • Robert D. Annett
    • 5
  1. 1.Psychology DepartmentUniversity of New MexicoAlbuquerqueUSA
  2. 2.Children’s Hospitals and Clinics of Minnesota, Psychology ServicesSt. PaulUSA
  3. 3.Division of Hematology/Oncology/BMTPrimary Children’s Medical CenterSalt Lake CityUSA
  4. 4.Pediatric Hematology/OncologyUniversity of Texas Health Science Center at San AntonioSan AntonioUSA
  5. 5.Department of Pediatrics and PsychologyUniversity of New Mexico Health Sciences CenterAlbuquerqueUSA

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