Brain morphology and information processing at the completion of chemotherapy-only treatment for pediatric acute lymphoblastic leukemia

ABSTRACT

Background: Approximately 50% of survivors of childhood acute lymphoblastic leukemia (ALL) demonstrate cognitive impairments. However, the trajectory of change and contributing neuropathology is unclear, limiting our ability to tailor intervention content and timing. This study aimed to explore information processing abilities and brain morphology early post-treatment for pediatric ALL.

Procedure: Twenty-one children at the end of ALL treatment and 18 controls underwent neuropsychological assessment. A subset also completed structural magnetic resonance imaging.

Results: A principal component analysis generated two cognitive factors: information processing capacity and information processing speed. Compared to control group, the ALL group displayed deficits in capacity, but not speed. No group differences were identified in morphology. No relationship was identified between capacity or speed and morphology.

Conclusion: Early cognitive intervention should target information processing abilities using a system-wide approach. Future studies should employ alternative imaging techniques sensitive to white-matter microstructure when exploring pathology underlying information processing deficits.

KEYWORDS:

• Acute lymphoblastic leukemia
• cognition
• information processing
• morphometry
• pediatric

Acknowledgments

We would like to extend our gratitude to the children, adolescents and families who kindly provided their time to participate in the study, the ALLaboard research team for data collection, and Chris Adamson for his assistance with the processing and analysis of imaging data.

This research was conducted within the Developmental Imaging research group, Murdoch Children’s Research Institute and the Children’s MRI Centre, and Royal Children’s Hospital, Melbourne, Victoria. It was supported by the Murdoch Children’s Research Institute, the Royal Children’s Hospital, Department of Paediatrics, The University of Melbourne, the Victorian Government’s Operational Infrastructure Support Program, and an Australian Government Research Training Program Scholarship.

Disclosure of interest

The authors report no conflict of interest.

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

This work was supported by The Leukaemia Foundation, The Royal Children’s Hospital Foundation and Monash Health.