Relationship between treatment protocols of ALL and late neurocognitive disorders.
acute lymphoblastic leukemia., childhood, neurocognitive disorders, methotrexate, chemotherapy intrathecal.
Combined efforts in the context of pediatric oncology towards establishing a balance between the increas surviving rates and the reduction of cognitive deficits and behavioral troubles among ALL (acute lymphoblastic leukemia) survivors have been identified during the last years. The present research effort aimed e of to investigate cognitive profiles of children and teenagers ALL survivors, previously submitted to two distinct treatment protocols, GBTLI LLA 1999 and BFM 2002. Two other independent variables were considered - the ages of participants when diagnosed and the amount of time after treatment. Treatment protocols differ essentially due to Methotrexate (MTX) dosage; this drug is the main agent in preventing central nervous system cells infiltration. Thirty-one children having finalized ALL treatment have participated in the present research; ages varied from six to twelve years, and all participants were under medical supervision by public community reference oncology services from the Brazilian state of Rio Grande do Norte. Two groups of subjects were constituted, taking into account treatment protocols and the other independent variables mentioned above. Neuropsychological evaluation covered the following cognitive abilities: intellectual capacity, executive functions, attention, visuospatial processing and visuo-construction. Data were categorized and analyzed with the support of statistical descriptive (uni and multidimensional cluster analysis) and inferential (Pearson Qui2) tools. Results showed that participants submitted to bigger MTX dosage, age level under five years at diagnosis and out of treatment for two or more years are more liable to develop cognitive deficits that could be associated to ALL and its medical treatment.