Neurocognitive impairment in Asian childhood cancer survivors: a systematic review

Peng, Liwen; Yam, Perri; Yang, Lei; Sato, Satomi; Li, Chi Kong; Cheung, Yin Ting

doi:10.1007/s10555-020-09857-y

Cited by 20 publications

(29 citation statements)

References 81 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A minority of survivors (4.0% to 36.2%) demonstrated moderate impairment on performance-based cognitive assessments across the domains of attention, executive function, motor processing speed and memory. Our results are consistent with those of studies in which ALL survivors were shown to exhibit deficits in these domains (4,7,26). Survivors reported more behavioral problems relative to the population norms, particularly in the domains of attention, a sluggish cognitive tempo and depressive symptoms.…”

Section: Discussionsupporting

confidence: 91%

“…To date, the majority of cognitive studies have involved Western populations. However, a recent systematic review identified 13 cognitive studies in survivors of childhood cancer in Asian countries, and found that 10.0%-42.8% of survivors demonstrated mild-to-moderate impairments in intelligence (i.e., overall IQ) (26). Evidence obtained in a Western population cannot be extrapolated to Asian survivors because of genetic differences in responses to drug therapies and susceptibilities to developing treatment-related chronic toxicities (27).…”

Section: Introductionmentioning

confidence: 99%

“…Few studies have examined the mediating effects of socioenvironmental factors on the functional outcomes of survivors (31). This is especially relevant in the Asian context, in which great emphasis has been placed on ameliorating the adverse health effects of an urban environment, such as sleep disturbances, a sedentary lifestyle and academic stress, on children and adolescents (26,32). Particularly, poor environmental factors and health behaviors may influence poorer neurocognitive and behavioral functions, especially in survivors who are already at risk of adverse health outcomes due to the cancer and related treatment.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Neurocognitive and Behavioral Outcomes of Chinese Survivors of Childhood Lymphoblastic Leukemia

et al. 2021

Self Cite

View full text Add to dashboard Cite

BackgroundIncreasing attention has been dedicated to investigate modifiable risk factors of late effects in survivors of childhood cancer. This study aims to evaluate neurocognitive and behavioral functioning in a relatively young cohort of survivors of childhood acute lymphoblastic leukemia (ALL) in Hong Kong, and to identify clinical and socio-environmental factors associated with these outcomes.MethodsThis analysis included 152 survivors of childhood ALL who were ≥5 years post-diagnosis (52% male, mean [SD] age 23.5[7.2] years at evaluation, 17.2[7.6] years post-diagnosis). Survivors completed performance-based neurocognitive tests, and reported their emotional and behavioral symptoms using the Child/Adult Behavior Checklist. Socio-environmental variables (living space, fatigue, physical activity, family functioning, and academic stress) were self-reported using validated questionnaires. Clinical variables and chronic health conditions were extracted from medical charts. Multivariable linear modeling was conducted to test identify factors associated with neurocognitive/behavioral outcomes, adjusting for current age, sex, age at diagnosis and cranial radiation. An exploratory mediation analysis was performed to examine the mediating effects of risk factors on neurocognitive and behavioral outcomes.ResultsAs compared to population norms, a minority of survivors developed mild-moderate impairment in motor processing speed (36.2%), memory (9.2%) and attention measures (4.0%-10.5%). Survivors also reported attention problems (12.5%), sluggish cognitive tempo (23.7%) and internalizing (depressive, anxiety and somatic symptoms) problems (17.1%). A minority of survivors developed mild-moderate treatment-related chronic conditions (n=37, 24.3%). As compared to survivors without chronic conditions, survivors with chronic conditions had more executive dysfunction (B=5.09, standard error [SE]=2.05; P=0.014) and reported more attention problems (B=5.73, SE=1.43; P<0.0001). Fatigue and poor family functioning was associated with multiple measures of behavior problems (all P<0.001). A lower level of physical activity was correlated with more self-reported symptoms of inattention (B= -1.12, SE=0.38, P=0.004) and sluggish cognitive tempo (B=-1.22, SE=0.41, P=0.003). Exploratory analysis showed that chronic health conditions were associated with behavioral measures through fatigue as the mediator.ConclusionThe majority of young Chinese survivors of ALL had normal cognitive and behavioral function. Regular monitoring of behavioral function should be performed on survivors who develop treatment-related chronic conditions. Health behavior and socio-environment factors may be potentially modifiable risk factors associated with health outcomes in survivors.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Neurocognitive and Behavioral Outcomes of Chinese Survivors of Childhood Lymphoblastic Leukemia

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…Similarly, treatment protocols are highly standardized, so that true variation in delivered treatment across the participants is likely limited. On the other hand, it is possible that the reported alterations in brain structure in ALL survivors are the result of a mix of factors that encompass clinical history, genetic variation ( Kamdar et al, 2011 ), medical complications ( Inaba et al, 2017 , Cheung et al, 2018 ), sociodemographic factors ( Peng et al, 2020 ), as well as their interactions ( Cheung et al, 2018 ). Elucidating the roles of each of these factors is complex.…”

Section: Discussionmentioning

confidence: 99%

Quantitative MRI outcomes in child and adolescent leukemia survivors: Evidence for global alterations in gray and white matter

Plas

Noakes

Butcher

et al. 2020

NeuroImage: Clinical

View full text Add to dashboard Cite

Highlights Studies of cognition in ALL survivors consistently show evidence of mild neurocognitive difficulties. Structural MRI showed widespread differences between survivors and controls. Gray and white matter volumes were respectively 5 and 6% smaller in survivors. Survivors also exhibited altered white matter diffusion overall.

show abstract

“…Data on neurocognitive outcome in survivors of ALL in LMICs is scarce. According to a review of neurocognitive impairment in Asian Cancer survivors, mild-to-moderate impairment was reported in 10.0-42.8% of survivors 13 . A large series of cancer survivors from India, showed scholastic problems and psychosocial problems in around 43% and 57% of the cohort, respectively 14 .…”

Section: Discussionmentioning

confidence: 99%

Title Page: Neurocogntive Outcomes in Survivors of Childhood Acute Lymphoblastic Leukemia: Experience From a Teritary Care Centre in India

Das¹,

Seth²,

Sapra³

et al. 2021

Preprint

View full text Add to dashboard Cite

BACKGROUND: Neurocognitive deficits are an important late effect in survivors of acute lymphoblastic Leukemia(ALL). Data from low middle income countries is scarce and highly influenced by biological and cultural variations. Such data would be useful for highlighting the importance of early intervention in an already disadvantaged population. PROCEDURE: 70 consecutive survivors of childhood ALL were evaluated for neurocognitive deficits by the Indian adaptation of Wechsler Intelligence Scale for Children-Fourth Edition(WISC-INDIA). Prevalence of neurocognitive deficits was calculated based on Full Scale Intelligence Quotient(FSIQ) and scores in discrete domains like Verbal Comprehension, Perceptual Reasoning, Working Memory and Processing Speed were calculated and compared to baseline characteristics, chemotherapy and radiation dose received. RESULTS: The mean FSIQ was 86.1 ± 20.5, with significant neurocognitive deficit(FSIQ <90) being prevalent in 50%(95% CI 38% to 62%) of the cohort. The proportion of survivors with deficits in individual domains of verbal comprehension, perceptual reasoning, working memory and processing speed were 49%, 50%, 47% and 44% respectively. The odds of having deficits in neurocognitive function was higher when a child belonged to lower socioeconomic strata, had parents with less than primary school education and whose birth order was higher(All p<0.05). Age at diagnosis, current age at assessment, receiving lower or higher dose of radiotherapy, high dose methotrexate or cytarabine did not have a direct impact on neurocognitive function. CONCLUSIONS AND RELEVANCE: The current need is to develop country specific neurocognition assessment tools to initiate early screening and develop culturally appropriate preventive and rehabilitative interventions.

show abstract

Neurocognitive impairment in Asian childhood cancer survivors: a systematic review

Cited by 20 publications

References 81 publications

Neurocognitive and Behavioral Outcomes of Chinese Survivors of Childhood Lymphoblastic Leukemia

Neurocognitive and Behavioral Outcomes of Chinese Survivors of Childhood Lymphoblastic Leukemia

Quantitative MRI outcomes in child and adolescent leukemia survivors: Evidence for global alterations in gray and white matter

Title Page: Neurocogntive Outcomes in Survivors of Childhood Acute Lymphoblastic Leukemia: Experience From a Teritary Care Centre in India

Contact Info

Product

Resources

About