Executive functions in aging adult survivors of childhood leukemia.

2010 ◽  
Vol 28 (15_suppl) ◽  
pp. 9011-9011 ◽  
Author(s):  
K. R. Krull ◽  
N. Jain ◽  
Z. Pan ◽  
K. Shine ◽  
D. K. Srivastava ◽  
...  
Keyword(s):  
Executive Functions ◽  
Childhood Leukemia ◽  
Adult Survivors ◽  
Aging Adult

scholarly journals 24 Radiation induced meningioma in adult survivors of childhood leukemia or primary brain tumor treated with cranial radiotherapy: Incidence and screening recommendations

2018 ◽  
Vol 45 (S3) ◽  
pp. S5-S5
Author(s):  
Maryam Dosani ◽  
Jordan Tran ◽  
Jessica L Conway ◽  
Karen Goddard
Keyword(s):  
Brain Tumor ◽  
Childhood Leukemia ◽  
Significant Risk ◽  
Retrospective Chart Review ◽  
Adult Survivors ◽  
Steady Increase ◽  
Cranial Radiotherapy ◽  
Radiation Induced ◽  
Age Range

Purpose: Cranial radiotherapy (CRT) was commonly given for childhood leukemia and brain tumors. Survivors are at risk of late effects including radiation induced meningioma (RIM). Surveillance for RIM is not standardized . We aimed to determine the incidence, latency, and screening patterns for RIM. Materials and Methods: Retrospective chart review of all patients aged <18 years at the time of radiation (RT), treated with CRT for leukemia or a brain tumor in BC between 1981-2006. Patient, tumor, and treatment characteristics were collected. Actuarial statistics were calculated with Kaplan-Meier Curves. Patients were censored at the date of last normal cranial imaging, or development of a RIM. Results: 392 patients were identified. Median age (range) at CRT was 9.6 years. Median CRT dose was 28Gy. The original diagnosis was leukemia in 50%, glioma in 13%, medulloblastoma in 8%, ependymoma in 7%, neuroectodermal tumor in 7%, germ cell tumor in 5%, craniopharyngioma in 4%, and other pathologies in 6%. Median (range) of clinical follow-up (FU) was 13.2 (0-37.5) years. Median (range) of cranial imaging FU was 15.5 (0-21.2) years. There was no documented cranial imaging FU in 144 patients. Forty-eight patients developed a RIM. The median age (range) at RT for patients with RIM was 6.7 years. Only 8 of these cases presented with associated symptoms. The earliest RIM in our cohort occurred 10.2 years after CRT. On actuarial analysis, the median (95% CI) time to development of a meningioma was 29.8 (28.9-30.7) years. Incidence (95% CI) of meningioma at 10 years was 0%, 15 years was 5 (2-9)%, 20 years was 12 (6-18)%, 25 years was 33 (23-43)% and 30 years was 47 (37-68)%. Amongst patients with a RIM, the median dose of CRT was 45 Gy. The lowest dose of RT in a patient who developed RIM was 12 Gy. RT was delivered to the whole brain in 58% and partial brain in 42% of patients with a RIM. Conclusions: After CRT in pediatric patients, there is a significant risk of developing a RIM and a steady increase in this risk with ongoing follow-up. We recommend standardization of surveillance for these patients with screening beginning 10 years after completion of CRT.

Employment in French young adult survivors of childhood leukemia: an LEA study (for Leucemies de l’Enfant et de l’Adolescent—childhood and adolescent leukemia)

2016 ◽  
Vol 10 (6) ◽  
pp. 1058-1066 ◽  
Author(s):  
Julie Berbis ◽  
Céline Reggio ◽  
Gérard Michel ◽  
Pascal Chastagner ◽  
Yves Bertrand ◽  
...  
Keyword(s):  
Young Adult ◽  
Childhood Leukemia ◽  
Adult Survivors ◽  
Young Adult Survivors

Regional Fat Deposition, Cardiorespiratory Fitness and Insulin Resistance in Adult Survivors of Childhood Leukemia

2006 ◽  
Vol 38 (Supplement) ◽  
pp. S203-S204
Author(s):  
Peter M. Janiszewski ◽  
Jennifer L. Kuk ◽  
Kevin C. Oeffinger ◽  
Timothy S. Church ◽  
Robert Ross
Keyword(s):  
Insulin Resistance ◽  
Cardiorespiratory Fitness ◽  
Childhood Leukemia ◽  
Adult Survivors ◽  
Fat Deposition

Corticosteriods, Neurocognition and Stress In Adult Survivors of Childhood Leukemia

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 738-738
Author(s):  
Kevin R. Krull ◽  
Leslie L. Robison ◽  
Robert J. Ferry ◽  
Melissa M. Hudson
Keyword(s):  
Emotional Regulation ◽  
Childhood Leukemia ◽  
Adult Survivors ◽  
Dexamethasone Suppression Test ◽  
Group Comparison ◽  
Increased Risk ◽  
Morning Cortisol ◽  
Neurocognitive Outcomes ◽  
Suppression Test ◽  
Dexamethasone Suppression

Abstract Abstract 738 While recent research has demonstrated comparable neurocognitive outcomes in survivors of childhood leukemia (ALL) treated with different types of corticosteroids during induction therapy, the long-term impact of prolonged corticosteroid therapy has not been investigated. We compared neurocognitive and physiologic outcomes in 37 adult survivors of childhood leukemia who were treated with only chemotherapy (i.e., no cranial radiation therapy) on one of two standard therapy protocols (21 treated with 20 g/m2 HD-IV methotrexate and repeated cycles of prednisone for two years; 16 treated with either 20 or 24 g/m2 HD-IV methotrexate and repeated cycles of dexamethasone for two years). Patients underwent neurocognitive evaluations, physical exams, and laboratory tests after overnight fasting. Morning cortisol was assessed at baseline and 12 h after 1 mg dexamethasone (standard dexamethasone suppression test). Groups were similar for male:female ratio (p=0.73), current age (p=0.90), and cumulative HD-IV methotrexate exposure (p=0.68). No differences were detected in final adult height (p=0.85), body mass index (p=0.43), HDL (p=0.86) or LDL (p=0.99) cholesterol, heart rate (p=0.49), triglycerides (p=0.59), serum glucose (p=0.84), insulin (p=0.63), HgA1C (p=0.62), free T4 (p=0.78), IGF-I (p=0.77), or basal morning cortisol (p=0.72). Survivors treated with dexamethasone displayed significantly higher systolic blood pressure compared to the prednisone exposure group (mean=128.5 ± SD 11.71 vs. 117.7±13.78; p=0.02), and a trend for higher diastolic BP (mean=75.1±9.33 vs. 68.7±10.55; p=0.08). Survivors originally treated with dexamethasone displayed significantly less suppression of cortisol following the dexamethasone suppression test (mean 3.82±6.41 μg/dL) compared to those originally treated with prednisone (0.94 ± 0.75 μg/dL; p=0.05). The dexamethasone group demonstrated significantly lower performance on multiple measures neurocognitive function (Tables 1), including mathematical problem solving (p=0.002), semantic verbal memory (p=0.006) and cognitive flexibility (p=0.02). They also reported more difficulty with emotional regulation (p=0.04). These results suggest that adult survivors of childhood leukemia treated with dexamethasone are at increased risk for neurocognitive impairment and poor emotional regulation. These problems may occur in the presence of symptoms of physical stress. Surprisingly, these survivors appear to display persistent late signs of increased reactivity within the hypothalamic-pituitary-adrenal axis. Table 1. Group comparison on neurocognitive outcomes. Neurocognitive Outcomes Prednisone (n=21) Dexamethasone (n=16) Group Comparison p-value Mean SD Mean SD Intellect 1 Vocabulary 100.2 15.56 86.4 18.72 0.02 Matrices 103.2 15.08 103.1 7.50 0.99 Academics 2 Reading 100.2 6.62 86.8 16.48 0.002 Mathematics 100.8 9.72 86.6 15.53 0.002 Processing Speed Reaction time3 45.0 9.35 50.5 10.97 0.12 Visual-Motor Speed4 11.6 3.29 8.8 3.44 0.02 Attention Focused5 102.1 17.98 96.1 19.01 0.35 Span6 101.1 11.11 97.4 16.68 0.43 Sustained3 56.2 20.41 54.3 12.73 0.76 Memory 7 Immediate Semantic 11.0 3.24 8.6 2.34 0.02 Delay Semantic 11.5 2.60 8.9 2.43 0.006 Spatial Locations 9.9 2.99 8.6 3.29 0.25 Facial Memory 10.7 3.16 9.6 2.79 0.31 Executive Function Working Memory6 101.3 9.97 94.5 14.66 0.11 Cognitive Flexibility5 103.1 14.63 84.0 31.89 0.02 Cognitive Fluency8 9.7 2.83 8.5 2.95 0.25 1 Wechsler Abbreviated Test of Intelligence; 2 Woodcock-Johnson-III; 3 Connors Continuous Performance Test-II; 4 Weschler Coding/Digit Symbol subtest; 5 Trail Making Test; 6 Wechsler Digit Span subtest (Forward=Span, Backward=Working Memory); 7 Test of Memory and Learning-II; 8 Controlled Oral Word Test. Disclosures: No relevant conflicts of interest to declare.

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