Longitudinal language outcomes following intrathecal chemotherapy for acute lymphoblastic leukaemia

Abstract

Intrathecal chemotherapy (ITC) is the treatment option for acute lymphoblastic leukaemia (ALL). Neurocognitive deficits have been described following ITC, but language status post-treatment is yet to be clarified. This study examined the language skills of nine children following ITC for ALL (mean age 7;8 years and 3;2 years post-diagnosis at baseline measurement) and nine age- and sex-matched controls, at baseline then 2 years later, using a battery of tests assessing general language skills. An assessment of cognitively-demanding high level language skills was undertaken on a sub-group of the children (n =12). Statistical analysis revealed no significant difference between children treated with ITC and controls when comparing change in performance scores from baseline measurement to 2 years post-baseline measurement. Descriptive analysis of three of the ALL participants in the Intermediate Stage survivorship at language re-assessment indicated no clinically-significant change in performance over 2 years for all measures except receptive language skills, which improved over the time for two of the children. As language skills continue to develop into late adolescence, the need for the monitoring of language abilities of children treated at a young age with ITC as they enter the Intermediate and Late Stages of survivorship is discussed.

Keywords::

• Intrathecal chemotherapy
• childhood acute lymphoblastic leukaemia
• general language skills
• high level language skills
• central nervous system prophylaxis

Acknowledgements

Financial support for the research was provided by Cancer Council Queensland (Grant 51145). The authors acknowledge the assistance of staff at the Royal Children's Hospital, Brisbane, Australia and the Mater Children's Hospital, Brisbane, Australia in the recruitment of children for the study. The researchers thank the participants and their families for their interest and support of the research. This article is a reworking of the second author's Honours thesis under the supervision of Dr Fiona Lewis.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.