Childhood intrathecal chemotherapy: Language outcomes 11 years on

Abstract

Background and objective: Studies suggest that major language indices do not differentiate children treated for acute lymphoblastic leukaemia (ALL) with intrathecal chemotherapy (ITC) from control children matched on age, gender and educational level. This case–/INS;control study used a sibling as a control to investigate language outcomes in a male child 11 years after the /INS;administration of ITC for ALL.

Method: The Index case was a male aged 13 years 8 months at the time of his involvement in the study. At age 2 years 3 months he was diagnosed with standard risk ALL and was treated with ITC. For the current study, the Index case underwent behavioural assessment of language skills and neurophysiological assessment of language processing efficiency, with performance measures being descriptively compared to performance by his younger sibling.

Results: Behavioural language testing failed to differentiate the siblings on current language performance, but neurophysiological assessment revealed that the ITC-treated child required more time to process information during a picture–/INS;word matching task.

Conclusions: The study's findings offer pilot data of language outcomes following ITC beyond the early stage of survivorship. Information processing speed is important for skill and knowledge acquisition in normal development and it has been proposed that a slowed rate of information processing may be the first indicator of emerging neurocognitive deficits in children following CNS-directed treatments. Thus the Index case may be at risk of “growing into deficit” as he develops adolescent language skills. The benefits and limitations of using siblings in research investigating cognitive outcomes are discussed.

Copyright © 2013 Published by Elsevier B.V.