A meta-analysis of the neuropsychological sequelae of chemotherapy-only treatment for pediatric acute lymphoblastic leukemia. Pediatric Blood

INTRODUCTION Research examining the neuropsychological outcomes of whole brain radiation therapy (RT) plus intrathecal (IT) chemotherapy for acute lymphoblastic leukemia (ALL) has indicated declines in nonverbal intelligence, math achievement, visual-motor integration, processing speed, attention, executive functioning, and memory Research suggests that the underlying basis for neuropsychological deficits may be the impact of radiation on white matter density, by which impaired myelinization affects nondominant hemisphere functions and slowed cortical activity One review of neuropsychological outcomes of CNS chemotherapy concluded that two-thirds of studies indicated decreased intellectual functioning in ALL survivors receiving chemotherapy compared to controls METHOD Article Identification We conducted literature searches using MEDLINE and PsycInfo databases and reference sections of relevant articles; additional details of search terms and inclusion/exclusion criteria can be found in the Supplementary materials. Following identification of relevant articles, each article was examined in detail by the authors to Background. Mixed findings on the neuropsychological sequelae of chemotherapy-only treatment for pediatric acute lymphoblastic leukemia (ALL), without radiation, indicate the need for a comprehensive meta-analytic review. The purpose of the current study was to conduct a meta-analysis assessing neuropsychological and academic functioning differences between children with ALL treated solely with chemotherapy and comparison groups. Procedures. Thirteen articles met inclusion criteria for the metaanalysis and were analyzed using a random effects model, weighted least squares methods. Results. Mean effect sizes were significantly different from zero for multiple domains of intelligence an