Developmental Outcome of Childhood Leukemia

Children treated for acute lymphoblastic leukemia, the most common cancer in childhood, are at risk for learning problems, including decreased IQ scores and deficits in mathematics, attention, and memory, both during their treatment phase and after cure. Psychosocial problems, particularly behavioral problems and social skills deficits, are reported as well. These problems occur across all age ranges but are most frequent in children who are less than 4 years old at the time of diagnosis. Up to two thirds of these children may have educational difficulties. To examine these issues more closely, the literature on developmental and psychosocial outcomes of childhood leukemia is reviewed, with particular attention to studies reporting on preschool-age children. Studies are categorized according to outcome measures used: (a) IQ or scholastic achievement tests, (b) neuropsychological performance tests, (c) memory or attention tests, and (d) psychosocial evaluation measurements. In each of these categories, evidence exists that preschool children treated for leukemia are at high risk for developmental difficulties. Suggestions are offered for developmental surveillance and educational interventions.