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Behavioral and educational
functioning in survivors of childhood acute lymphoblastic leukemia
In a multi-center study, behavioral functioning and school performance was examined in children at least one year after finishing treatment with chemotherapy, without cranial irradiation, for ALL (n = 28) or a Wilms’ tumor (n = 36). They were compared with siblings (n = 37) and with a control group of healthy school children (n = 98). While survivors of a Wilms’ tumor and siblings were functioning normally, subtle behavioral and educational sequelae were found in survivors of ALL. School performance was poorer in children with ALL attending primary school compared to same-age peers, however, the rate of utilization of special education services was low. Attentional dysfunction was associated with poorer mathematics performance and with teacher-rated behavior problems in children with ALL. Higher treatment intensity was a risk factor for school problems in this group. In conclusion, even though cranial irradiation is
currently omitted from most treatment protocols for children with ALL, in
their follow-up careful attention to possible behavioral and educational
problems is indicated, so that appropriate assessment and intervention can
be initiated when necessary.
Bibliographical reference:
Annemieke Buizer Department of Pediatric Hematology-Oncology, VU University Medical Center, Amsterdam, Netherlands
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