A meta-analysis of the neuropsychological sequelae of chemotherapy-only treatment for pediatric acute lymphoblastic leukemia

Abstract

Background Mixed findings on the neuropsychological sequelae of chemotherapy-only treatment for pediatric acute lymphoblastic leukemia (ALL), without radiation, indicate the need for a comprehensive meta-analytic review. The purpose of the current study was to conduct a meta-analysis assessing neuropsychological and academic functioning differences between children with ALL treated solely with chemotherapy and comparison groups. Procedure Thirteen articles met inclusion criteria for the meta-analysis and were analyzed using a random effects model, weighted least squares methods. Results Mean effect sizes were significantly different from zero for multiple domains of intelligence and academic achievement; processing speed; verbal memory; and some aspects of executive functioning and fine motor skills, indicating worse functioning in ALL survivors. Effect sizes for visual-motor skills and visual memory were not significantly different from zero. Conclusions Results support the presence of neuropsychological and academic sequelae for ALL survivors treated solely with chemotherapy and highlight the need for ongoing follow-up of children with ALL using a standardized neuropsychological test battery and research methodology. Pediatr Blood Cancer 2008;51:99–104. © 2008 Wiley-Liss, Inc.