Neuropsychological Test Performance of Pediatric Cancer Patients at Diagnosis and One Year Later

More children with cancer are surviving, and the effects ofmedical treatments are of interest to patients, parents, educators,and the treatment team, since results may influence furthertreatment planning and delivery of educational services. Longitudinalinvestigations employing baseline measures are essential todistinguish preexisting learning problems from treatment effectsand transient effects from long-term sequelae. In this report,neuropsychological test performance is compared at baselineand 1 year postdiagnosis between 19 leukemia patients who receivedcentral nervous system and systemic chemotherapy and 19 patientswho received only systemic chemotherapy. Patients were evaluatedwith a comprehensive test battery developed for children toassess general intelligence, memory, language, academic achievement,and visual-spatial and constructional, tactile-perceptual, andfine-motor skills. No significant treatment group, time, orinteraction effects were obtained for higher order cognitiveabilities (intelligence, memory, language, academic achievement).Mean scores for both groups on these measures were within thenormal range. Significant treatment group effects were obtainedon tasks requiring fine-motor and tactile-perceptual skills.An interaction effect was noted on the tactile-perceptual test,in which the performace of one group improved, while that ofthe other group declined. Results are discussed in relationto the preservation of higher order cofnitive abilities andthe peripheral effects of systemically administered chemotherapies.