Effects of CNS Prophylaxis on the Neuropsychological Performance of Children With Acute Lymphoblastic Leukemia: Nine Months Postdiagnosis

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Abstract
Neuropsychological testing was completed 9 months after diagnosis on 42 children ages 6.5 years and older with "intermediate"-risk acute lymphoblastic leukemia (ALL) to determine the effects of ALL and its treatments in the first year following diagnosis. Each child was randomized to receive either 1800 cGy of central nervous system (CNS) irradiation plus intrathecal methotrexate (IT Mtx) or IT Mtx only as prophylaxis to prevent the occurrence of CNS leukemia. The groups were comparable in chronological age, socioeconomic status (SES), and sex ratio. The number of significant differences between groups was equal to what might be expected by chance alone. Covariance analysis with SES and age as covariates revealed these two variables were more related to neuropsychological status than was the CNS prophylaxis grouping. Comparison with other studies is made and implications for longitudinal follow-up are discussed.