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Behavioral and educational limitations after chemotherapy for childhood acute lymphoblastic leukemia or Wilms tumor
Author(s) -
Buizer Annemieke I.,
de Sonneville Leo M. J.,
van den HeuvelEibrink Marry M.,
Veerman Anjo J. P.
Publication year - 2006
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.21820
Subject(s) - medicine , wilms' tumor , chemotherapy , pediatrics , childhood cancer , lymphoblastic leukemia , cancer , el niño , leukemia
BACKGROUND The improved prognosis of childhood cancer makes monitoring of functional outcome important. The purpose of this study was to evaluate behavioral and educational functioning in survivors of childhood acute lymphoblastic leukemia (ALL) or a Wilms tumor. In this study, children with ALL received central nervous system directed chemotherapy without cranial irradiation. METHODS In a multicenter study, behavioral functioning and school performance was examined in 199 children age 4 to 18. Sixty‐four children were at least 1 year from finishing treatment with chemotherapy for ALL ( n = 28) or a Wilms tumor ( n = 36). They were compared with siblings ( n = 37) and with a control group of healthy schoolchildren ( n = 98). RESULTS A moderately increased risk of behavioral and educational problems was found in children with ALL but not in children with Wilms tumor. School performance was poorer in children with ALL attending primary school compared with same‐age peers; however, the rate of utilization of special education services was low. Teacher‐rated behavior and mathematics performance was correlated with attention function in children with ALL. An excess of problem behavior and underperformance at school was found in the ALL high‐risk group compared with the standard‐risk group. No differences were found between siblings and controls. CONCLUSION Evidence is provided of subtle but significant behavioral and educational problems in survivors of childhood ALL, but no dysfunctions in survivors of a Wilms tumor. Careful follow‐up of children with ALL treated with chemotherapy only is warranted. Cancer 2006. © 2006 American Cancer Society.