353
Views
2
CrossRef citations to date
0
Altmetric
Articles

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

, , , , &
Pages 293-302 | Received 17 Apr 2018, Accepted 21 Jun 2018, Published online: 03 Jul 2018

References

  • Mughal T, Goldman J, Mughal S. Understanding leukemias lymphomas and myelomas. Florida, USA: Taylor & Francis Group; 2009. 157.
  • Pui CH, Evans WE. A 50-year journey to cure childhood acute lymphoblastic leukemia. Semin Hematol. 2013;50(3):185–96. doi:10.1053/j.seminhematol.2013.06.007.
  • Vora A, Goulden N, Wade R, Mitchell C, Hancock J, Hough R, Rowntree C, Richards S. Treatment reduction for children and young adults with low-risk acute lymphoblastic leukaemia defined by minimal residual disease (UKALL 2003): A randomised controlled trial. Lancet Oncol. 2013;14(3):199–209. doi:10.1016/S1470-2045(12)70600-9.
  • Cheung YT, Krull KR. Neurocognitive outcomes in long-term survivors of childhood acute lymphoblastic leukemia treated on contemporary treatment protocols: A systematic review. Neurosci Biobehav Rev. 2015;53:108–20. doi:10.1016/j.neubiorev.2015.03.016.
  • Duffner PK, Armstrong FD, Chen L, Helton KJ, Brecher ML, Bell B, Chauvenet AR. Neurocognitive and neuroradiologic central nervous system late effects in children treated on Pediatric Oncology Group (POG) P9605 (standard risk) and P9201 (lesser risk) acute lymphoblastic leukemia protocols (ACCL0131): a methotrexate consequence? A report from the Children’s Oncology Group. J Pediatr Hematol Oncol. 2014;36(1):8–15. doi:10.1097/MPH.0000000000000000.
  • Kanellopoulos A, Andersson S, Zeller B, Tamnes CK, Fjell AM, Walhovd KB, Westlye LT, Fossa SD, Ruud E. Neurocognitive outcome in very long-term survivors of childhood acute lymphoblastic leukemia after treatment with chemotherapy only. Pediatr Blood Cancer. 2016;63(1):133–38. doi:10.1002/pbc.25690.
  • Krull KR, Brinkman TM, Li C, Armstrong GT, Ness KK, Srivastava DK, Gurney JG, Kimberg C, Krasin MJ, Ch P and others. Neurocognitive outcomes decades after treatment for childhood acute lymphoblastic leukemia: a report from the St Jude lifetime cohort study. J Clin Oncol. 2013;31(35):4407–15. doi:10.1200/JCO.2012.48.2315.
  • Aukema EJ, Caan MW, Oudhuis N, Majoie CB, Vos FM, Reneman L, Last BF, Grootenhuis MA, Schouten-Van Meeteren AY. White matter fractional anisotropy correlates with speed of processing and motor speed in young childhood cancer survivors. Int J Radiat Oncol Biol Phys. 2009;74(3):837–43. doi:10.1016/j.ijrobp.2008.08.060.
  • Edelmann MN, Ogg RJ, Scoggins MA, Brinkman TM, Sabin ND, Pui CH, Srivastava DK, Robison LL, Hudson MM, Krull KR. Dexamethasone exposure and memory function in adult survivors of childhood acute lymphoblastic leukemia: A report from the SJLIFE cohort. Pediatric Blood & Cancer. 2013;60(11):1778–84. doi:10.1002/pbc.24644.
  • Peterson CC, Johnson CE, Ramirez LY, Huestis S, Pai AL, Demaree HA, Drotar D. A meta-analysis of the neuropsychological sequelae of chemotherapy-only treatment for pediatric acute lymphoblastic leukemia. Pediatr Blood Cancer. 2008;51(1):99–104. doi:10.1002/pbc.21544.
  • Campbell LK, Scaduto M, Sharp W, Dufton L, Van Slyke D, Whitlock JA, Compas B. A meta-analysis of the neurocognitive sequelae of treatment for childhood acute lymphocytic leukemia. Pediatr Blood Cancer. 2007;49(1):65–73. doi:10.1002/pbc.20860.
  • Nathan PC, Patel SK, Dilley K, Goldsby R, Harvey J, Jacobsen C, Kadan-Lottick N, McKinley K, Millham AK, Moore I and others. Guidelines for identification of, advocacy for, and intervention in neurocognitive problems in survivors of childhood cancer: A report from the Children’s Oncology Group. Arch Pediatr Adolesc Med. 2007;161(8):798–806. doi:10.1001/archpedi.161.8.798.
  • Brown RT, Sawyer MG, Antoniou G, Toogood I, Rice M. Longitudinal follow-up of the intellectual and academic functioning of children receiving central nervous system-prophylactic chemotherapy for leukemia: A four-year final report. J Dev Behav Pediatrics. 1999;20(5):373–77. doi:10.1097/00004703-199910000-00013.
  • Iyer NS, Balsamo LM, Bracken MB, Kadan-Lottick NS. Chemotherapy-only treatment effects on long-term neurocognitive functioning in childhood ALL survivors: a review and meta-analysis. Blood. 2015;126(3):346–53. doi:10.1182/blood-2015-02-627414.
  • Cowan N. Evolving conceptions of memory storage, selective attention, and their mutual constraints within the human information-processing system. Psychological Bulletin. 1988;104:163–91.
  • Conklin HM, Helton S, Ashford J, Mulhern RK, Reddick WE, Brown R, Bonner M, Jasper BW, Wu S. Xiong X and others. Predicting methylphenidate response in long-term survivors of childhood cancer: A randomized, double-blind, placebo-controlled, crossover trial. J Pediatr Psychol. 2009;35(2):144–55. doi:10.1093/jpepsy/jsp044.
  • Conklin HM, Ogg RJ, Ashford JM, Scoggins MA, Zou P, Clark KN, Martin-Elbahesh K, Hardy KK, Merchant TE. Jeha S and others. Computerized cognitive training for amelioration of cognitive late effects among childhood cancer survivors: A randomized controlled trial. J Clin Oncol. 2015;33(33):3894–902. doi:10.1200/JCO.2015.61.6672.
  • Kesler SR, Lacayo NJ, Jo B. A pilot study of an online cognitive rehabilitation program for executive function skills in children with cancer-related brain injury. Brain Inj. 2011;25(1):101–12. doi:10.3109/02699052.2010.536194.
  • Conklin HM, Ashford JM, Clark KN, Martin-Elbahesh K, Hardy KK, Merchant TE, Ogg RJ, Jeha S, Huang L, Zhang H. Long-term efficacy of computerized cognitive training among survivors of childhood cancer: A single-blind randomized controlled trial. J Pediatr Psychol. 2017;42(2):220–31. doi:10.1093/jpepsy/jsw057.
  • Asato R, Akiyama Y, Ito M, Kubota M, Okumura R, Miki Y, Konishi J, Mikawa H. Neuclear magnetic resonance abnormalities of the cerebral white matter in children with acute lymphoblastic leukemia and malignant lymphoma during and after central nervous system prophylactic treatment with intrathecal methotrexate. Cancer. 1997;70(7):1997–2004. doi:10.1002/1097-0142(19921001)70:7<1997::AID-CNCR2820700732>3.0.CO;2-G.
  • Hertzberg H, Huk W, Ueberall M, Langer T, Meier W, Dopfer R, Skalej M, Lackner H, Bode U. Janssen G and others. CNS late effects after ALL therapy in childhood. Part I: neuroradiological findings in long-term survivors of childhood ALL: an evaluation of the interferences between morphology and neuropsychological performance. Pediatric Blood & Cancer. 1997;28:387–400.
  • Reddick WE, Glass JO, Helton KJ, Langston JW, Li CS, Pui CH. A quantitative MR imaging assessment of leukoencephalopathy in children treated for acute lymphoblastic leukemia without irradiation. American Journal of Neuroradiology. 2005;26:2371–77.
  • Montour-Proulx I, Kuehn SM, Keene DL, Barrowman NJ, Hsu E, Matzinger MA, Dunlap H, Halton JM. Cognitive changes in children treated for acute lymphoblastic leukemia with chemotherapy only according to the pediatric oncology group 9605 protocol. J Child Neurol. 2005;20(2):129–33. doi:10.1177/08830738050200020901.
  • Pääkkö E, Vainionpää L, Pyhtinen J, Lanning M. Minor changes on cranial MRI during treatment in children with acute lymphoblastic leukaemia. Pediatr Neuroradiology. 1996;38(3):264–68. doi:10.1007/BF00596544.
  • Paakko E, Harila-Saari A, Vanionpaa L, Himanen S, Pyhtinen J, Lanning M. White matter changes on MRI during treatment in children with acute lymphoblastic leukemia: correlation with neuropsychological findings. Med Pediatr Oncol. 2000;35(5):456–61. doi:10.1002/1096-911X(20001101)35:5<456::AID-MPO3>3.0.CO;2-1.
  • Reddick WE, Glass JO, Johnson DP, Laningham FH, Pui CH. Voxel-based analysis of T2 hyperintensities in white matter during treatment of childhood leukemia. American Journal of Neuroradiology. 2009;30(10):1947–54. doi:10.3174/ajnr.A1733.
  • Wilson D, Nitschke R, Bowman M, Chaffin M, Sexauer C, Prince J. Transient white matter changes on MR images in children undergoing chemotherapy for acute lymphocytic leukemia: correlation with neuropsychologic deficiencies. Radiology. 1991;180(1):205–09. doi:10.1148/radiology.180.1.2052695.
  • Bhojwani D, Sabin ND, Pei D, Yang JJ, Khan RB, Panetta JC, Krull KR, Inaba H, Rubnitz JE. Metzger ML and others. Methotrexate-induced neurotoxicity and leukoencephalopathy in childhood acute lymphoblastic leukemia. J Clin Oncol. 2014;32(9):949–59. doi:10.1200/JCO.2013.53.0808.
  • Billiet T, Elens I, Sleurs C, Uyttebroeck A, D’Hooge R, Lemiere J, Deprez S. Brain connectivity and cognitive flexibility in nonirradiated adult survivors of childhood leukemia. JCNI. 2018; ePub ahead of print, 5 March doi:10.1093/jnci/djy009
  • Reddick WE, Shan ZY, Glass JO, Helton S, Xiong X, Wu S, Bonner MJ, Howard SC, Christensen R. Khan RB and others. Smaller white-matter volumes are associated with larger deficits in attention and learning among long-term survivors of acute lymphoblastic leukemia. Cancer. 2006;106(4):941–49. doi:10.1002/cncr.21679.
  • Zajac-Spychala O, Pawlak MA, Karmelita-Katulska K, Pilarczyk J, Derwich K, Wachowiak J. Long-term brain structural magnetic resonance imaging and cognitive functioning in children treated for acute lymphoblastic leukemia with high-dose methotrexate chemotherapy alone or combined with CNS radiotherapy at reduced total dose to 12 Gy. Neuroradiology. 2017;59(2):147–56. doi:10.1007/s00234-016-1777-8.
  • Kesler SR, Tanaka H, Koovakkattu D. Cognitive reserve and brain volumes in pediatric acute lymphoblastic leukemia. Brain Imag Behavior. 2010;4(3–4):256–69. doi:10.1007/s11682-010-9104-1.
  • Carey ME, Haut MW, Reminger SL, Hutter JJ, Theilmann R, Kaemingk KL. Reduced frontal white matter volume in long-term childhood leukemia survivors: a voxel-based morphometry study. AJNR: Am J Neuroradiology. 2008;29(4):792–97. doi:10.3174/ajnr.A0904.
  • Edelmann MN, Krull KR, Liu W, Glass JO, Ji Q, Ogg RJ, Sabin ND, Srivastava DK, Robison LL. Hudson MM and others. Diffusion tensor imaging and neurocognition in survivors of childhood acute lymphoblastic leukaemia. Brain. 2014;137(Pt 11):2973–83. doi:10.1093/brain/awu230.
  • Porto L, Preibisch C, Hattingen E, Bartels M, Lehrnbecher T, Dewitz R, Zanella F, Good C, Lanfermann H. DuMesnil R and others. Voxel-based morphometry and diffusion-tensor MR imaging of the brain in long-term survivors of childhood leukemia. Eur Radiol. 2008;18(11):2691–700. doi:10.1007/s00330-008-1038-2.
  • Genschaft M, Huebner T, Plessow F, Ikonomidou VN, Abolmaali N, Krone F, Hoffmann A, Holfeld E, Vorwerk P. Kramm C and others. Impact of chemotherapy for childhood leukemia on brain morphology and function. PLoS ONE [Electronic Resource]. 2013;8:11. doi:10.1371/journal.pone.0078599.
  • Kesler SR, Gugel M, Pritchard-Berman M, Lee C, Kutner E, Hosseini SM, Dahl G, Lacayo N. Altered resting state functional connectivity in young survivors of acute lymphoblastic leukemia. Pediatric Blood & Cancer. 2014;61(7):1295–99. doi:10.1002/pbc.25022.
  • Tamnes CK, Zeller B, Amlien IK, Kanellopoulos A, Andersson S, Due-Tonnessen P, Ruud E, Walhovd KB, Fjell AM. Cortical surface area and thickness in adult survivors of pediatric acute lymphoblastic leukemia. Pediatr Blood Cancer. 2015. doi:10.1002/pbc.25386.
  • Krull KR, Cheung YT, Liu W, Fellah S, Reddick WE, Brinkman TM, Kimberg C, Ogg R, Srivastava D. Pui CH and others. chemotherapy pharmacodynamics and neuroimaging and neurocognitive outcomes in long-term survivors of childhood acute lymphoblastic leukemia. J Clin Oncol. 2016;34(22):2644–53. doi:10.1200/JCO.2015.65.4574.
  • Vijayakumar N, Allen NB, Youssef G, Dennison M, Yucel M, Simmons JG, Whittle S. Brain development during adolescence: A mixed-longitudinal investigation of cortical thickness, surface area, and volume. Hum Brain Mapp. 2016;37(6):2027–38. doi:10.1002/hbm.23154.
  • Giedd JN, Blumenthal J, Jeffries NO, Castellanos FX, Liu H, Zijdenbos A, Paus T, Evans AC, Rapoport JL. Brain development during childhood and adolescence: a longitudinal MRI study. Nat Neurosci. 1999;2(10):861–63. doi:10.1067/mpd.2001.117066.
  • Benes FM, Turtle M, Khan Y, Farol P. Myelination of a key relay zone in the hippocampal formation occurs in the human brain during childhood, adolescence, and adulthood. Arch Gen Psychiatry. 1994;51(6):447–84. doi:10.1001/archpsyc.1994.03950060041004.
  • Pontious A, Kowalczyk T, Englund C, Hevner RF. Role of intermediate progenitor cells in cerebral cortex development. Dev Neurosci. 2007;301:24–32.
  • Armstrong E, Schleicher A, Omran H, Curtis M, Zilles K. The ontogeny of human gyrification. Cerebral Cortex. 1995;5:56–63.
  • Hearps SJ, Seal M, Anderson VA, McCarthy M, Connellan M, Downie P, DeLuca C. The relationship between cognitive and neuroimaging outcomes in children treated for Acute Lymphoblastic Leukemia with chemotherapy-only: A systematic review. Pediatric Blood & Cancer. 2017;64(2):225–33. doi:10.1002/pbc.26188.
  • Zajac-Spychala O, Pawlak M, Karmelita-Katulska K, Pilarczyk J, Jonczyk-Potoczna K, Przepiora A, Derwich K, Wachowiak J. Anti-leukemic treatment-induced neurotoxicity in long-term survivors of childhood acute lymphoblastic leukemia: impact of reduced central nervous system radiotherapy and intermediate- to high-dose methotrexate. Leuk Lymphoma. 2018;1–10. doi:10.1080/10428194.2018.1434879.
  • Bookheimer SY. Methodological issues in pediatric neuroimaging. Ment Retard Dev Disabil Res Rev. 2000;6:161–65. doi:10.1002/1098-2779(2000)6:3<161::AID-MRDD2>3.0.CO;2-W.
  • Kingma A, Van Dommelen RI, Mooyaart EL, Wilmink JT, Deelman BG, Kamps WA. Slight cognitive impairment and magnetic resonance imaging abnormalities but normal school levels in children treated for acute lymphoblastic leukemia with chemotherapy only. J Pediatrics. 2001;139:413–20.
  • Ashford J, Schoffstall C, Reddick WE, Leone C, Laningham FH, Glass JO, Pei D, Cheng C, Pui CH, Conklin HM. Attention and working memory abilities in children treated for acute lymphoblastic leukemia. Cancer. 2010;116(19):4638–45. doi:10.1002/cncr.25343.
  • Harila-Saari A, Pääkkö E, Vainionpää L, Pyhtinen J, Lanning B. A longitudinal magnetic resonance imaging study of the brain in survivors in childhood acute lymphoblastic leukemia. Cancer. 1998;83:2608–17.
  • Wechsler D. Wechsler abbreviated scale of intelligence. 2nd ed. Bloomington (MN): Pearson; 2011.
  • Wechsler D. Wechsler intelligence scale for children. 4th ed. Bloomington (MN): Pearson; 2003.
  • Wechsler D, Coalson DL, Raiford SE. WAIS-IV: wechsler adult intelligence scale. San Antonio (TX): Pearson; 2008.
  • Wechsler D. WISC-IV Australian technical and interpretive manual. Sydney (NSW): Pearson; 2003.
  • Wechsler D. WAIS-IV techincal and interpretive manual. San Antono (TX): Pearson; 2008.
  • CANTAB®[Cognitive assessment software]. Cambridge Cognition (2018). All rights reserved. http://www.cantab.com
  • Syvaoja HJ, Tammelin TH, Ahonen T, Rasanen P, Tolvanen A, Kankaanpaa A, Kantomaa MT. Internal consistency and stability of the CANTAB neuropsychological test battery in children. Psychol Assess. 2015;27(2):698–709. doi:10.1037/a0038485.
  • Nkhoma OW, Duffy ME, Cory-Slechta DA, Davidson PW, McSorley EM, Strain JJ, O’Brien GM. Early-stage primary school children attending a school in the Malawian school feeding program (SFP) have better reversal learning and lean muscle mass growth than those attending a non-SFP school. J Nutr. 2013;143(8):1324–30. doi:10.3945/jn.112.171280.
  • Luciana M. Practitioner review: computerized assessment of neuropsychological function in children: clinical and research applications of the cambridge neuropsychological testing automated battery (CANTAB). J Psychol Psychiatry. 2003;44:649–63.
  • Fischl B. Freesurfer. Neuroimage. 2012;62(2):774–81. doi:10.1016/j.neuroimage.2012.01.021.
  • Destrieux C, Fischl B, Dale A, Halgren E. Automatic parcellation of human cortical gyri and sulci using standard anatomical nomenclature. Neuroimage. 2010;53(1):1–15. doi:10.1016/j.neuroimage.2010.06.010.
  • StataCorp. Stata statistical software. College Station (TX): StataCorp LP; 2013.
  • Mann HB. On a test of whether one of two random variables is stochastically larger than the other. Ann Math Stat. 1947;18(1):50–60. doi:10.1214/aoms/1177730491.
  • Darling SJ, De Luca C, Anderson V, McCarthy M, Hearps SJC, Seal ML. White matter microstructure and information processing at the completion of chemotherapy-only treatment for pediatric acute lymphoblastic leukemia. Dev Neuropsychol. 2018;43:385–402. doi:10.1080/87565641.2018.1473401.
  • Zwick WR, Velicer WF. Comparison of five rules for determining the number of components to retain. Psychological Bulletin. 1986;99(9):432–42. doi:10.1037/0033-2909.99.3.432.
  • Horn JL. A rationale and test for the number of factors in factor analysis. Psychometrika. 1965;30:179–85.
  • Stevens JP. Applied multivariate statistics for the social sciences. Hillsdale (NJ): Erlbaum; 2002.
  • McGraw KO, Wong SP. A common language effect size statistic. Psychological Bulletin. 1992;111(2):361–65. doi:10.1037/0033-2909.111.2.361.
  • Liu SX. Effect size Statistical power analysis for the social and behavioral sciences: basic and advanced techniques. New York (NY): Taylor and Francis; 2013.
  • Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale (NJ): Lawrence Earlbaum Associates; 1988.
  • Benjamini Y, Hochberg Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. J Royal Stat Soc. 1995;57:289–300.
  • Tabachnick BG, Fidell LS. Principal components and factor analysis. Using multivariate statistics. 3rd ed. New York (NY): HarperCollins; 1996. p. 635–708.
  • Ramsey NF, Jansma JM, Jager G, Van Raalten T, Kahn RS. Neurophysiological factors in human information processing capacity. Brain. 2004;127(Pt 3):517–25. doi:10.1093/brain/awh060.
  • Jacola LM, Krull KR, Pui CH, Pei D, Cheng C, Reddick WE, Conklin HM. Longitudinal assessment of neurocognitive outcomes in survivors of childhood acute lymphoblastic leukemia treated on a contemporary chemotherapy protocol. J Clin Oncol. 2016;34(11):1239–47. doi:10.1200/JCO.2015.64.3205.
  • Lesnik P, Ciesielski K, Hart B, Benzel E, Sanders J. Evidence for cerebellar-frontal subsystem changes in children treated with intrathecal chemotherapy for leukemia: enhanced data analysis using an effect size model. Arch Neurol. 1998;55:1561–68.
  • Buizer AI, De Sonneville LM, Van den Heuvel-Eibrink MM, Veerman AJ. Chemotherapy and attentional dysfunction in survivors of childhood acute lymphoblastic leukemia: effect of treatment intensity. Pediatr Blood Cancer. 2005;45(3):281–90. doi:10.1002/pbc.20397.
  • Kim SJ, Park MH, Lee JW, Chung NG, Cho B, Lee IG, Chung SY. Neurocognitive outcome in survivors of childhood acute lymphoblastic leukemia: experience at a tertiary care hospital in Korea. J Korean Med Sci. 2015;30(4):463–69. doi:10.3346/jkms.2015.30.4.463.
  • Burgaleta M, Johnson W, Waber DP, Colom R, Karama S. Cognitive ability changes and dynamics of cortical thickness development in healthy children and adolescents. Neuroimage. 2014;84:810–19. doi:10.1016/j.neuroimage.2013.09.038.
  • Menary K, Collins PF, Porter JN, Muetzel R, Olson EA, Kumar V, Steinbach M, Lim KO, Luciana M. Associations between cortical thickness and general intelligence in children, adolescents and young adults. Intelligence. 2013;41(5):597–606. doi:10.1016/j.intell.2013.07.010.
  • Tamnes CK, Ostby Y, Walhovd KB, Westlye LT, Due-Tonnessen P, Fjell AM. Neuroanatomical correlates of executive functions in children and adolescents: a magnetic resonance imaging (MRI) study of cortical thickness. Neuropsychologia. 2010;48(9):2496–508. doi:10.1016/j.neuropsychologia.2010.04.024.
  • Zeller B, Tamnes CK, Kanellopoulos A, Amlien IK, Andersson S, Due-Tonnessen P, Fjell AM, Walhovd KB, Westlye LT, Ruud E. Reduced neuroanatomic volumes in long-term survivors of childhood acute lymphoblastic leukemia. J Clin Oncol. 2013;31(17):2078–85. doi:10.1200/JCO.2012.47.4031.
  • Durston S, Casey BJ. What have we learned about cognitive development from neuroimaging? Neuropsychologia. 2006;44(11):2149–57. doi:10.1016/j.neuropsychologia.2005.10.010.
  • Saykin AJ, Ahles TA, McDonald BC. Mechanisms of chemotherapy-induced cognitive disorders: neuropsychological, pathophysiological, and neuroimaging perspectives. Semin Clin Neuropsychiatry. 2003;8:201–16.
  • Landier W, Bhatia S, Eshelman DA, Forte KJ, Sweeney T, Hester AL, Darling J, Armstrong FD, Blatt J, Constine LS and others. Development of risk-based guidelines for pediatric cancer survivors: the children’s oncology group long-term follow-up guidelines from the children’s oncology group late effects committee and nursing discipline. J Clin Oncol. 2004;22(24):4979–90. doi:10.1200/JCO.2004.11.032.
  • Annett RD, Patel SK, Phipps S. Monitoring and assessment of neuropsychological outcomes as a standard of care in pediatric oncology. Pediatr Blood Cancer. 2015;62(Suppl 5):S460–513. doi:10.1002/pbc.25749.
  • Butler R. A case of acute lymphocytic leukemia. In: Morgan JE IBJR, editor. Casebook of clinical neuropsychology. New York (NY): Oxford University Press; 2011. p. 421–26.
  • Cole PD, Kamen BA. Delayed neurotoxicity associated with therapy for children with acute lymphoblastic leukemia. Ment Retard Dev Disabil Res Rev. 2006;12(3):174–83. doi:10.1002/mrdd.20113.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.