小児急性リンパ性白血病患児における認知機能の前方視的多施設協同研究

佐藤 聡美; 瀧本 哲也; 小阪 嘉之; 佐藤 篤; 湯坐 有希; 康 勝好; 角南 勝介; 種山 雄一; 堀 壽成; 太田 節雄; 松本 公一; 多賀 崇; 渡辺 新; 滝田 順子; 野村 恵子; 金兼 弘和; 陳 基明; 早川 晶; 福島 敬; 加藤 実穂; 大六 一志

doi:10.11412/jspho.58.424

Original Article

Neurocognitive performance of Japanese children with acute lymphoblastic leukemia: a prospective longitudinal study

Satomi Sato, Tetsuya Takimoto, Yoshiyuki Kosaka, Atsushi Sato, Yuki Yuza, Katsuyoshi Koh, Shosuke Sunami, Yuichi Taneyama, Toshinari Hori, Setsuo Ota, Kimikazu Matsumoto, Takashi Taga, Arata Watanabe, Junko Takita, Keiko Nomura, Hirokazu Kanegane, Motoaki Chin, Akira Hayakawa, Takashi Fukushima, Miho Kato, Hitoshi Dairoku

Author information

Satomi Sato
Graduate School of Public Health, St. Luke’s International University
Tetsuya Takimoto
Department of Children’s Cancer Data Management, National Center for Child Health and Development
Yoshiyuki Kosaka
Department of Hematology and Oncology, Hyogo Prefectural Kobe Children’s Hospital
Atsushi Sato
Department of Hematology and Oncology, Miyagi Children’s Hospital
Yuki Yuza
Department of Hematology/Oncology, Tokyo Metropolitan Children’s Medical Center
Katsuyoshi Koh
Department of Hematology/Oncology, Saitama Children’s Medical Center
Shosuke Sunami
Department of Pediatric Hematology and Oncology, Japanese Red Cross Narita Hospital
Yuichi Taneyama
Department of Hematology/Oncology, Chiba Children’s Hospital
Toshinari Hori
Department of Pediatrics, Aichi Medical University Hospital
Setsuo Ota
Department of Pediatrics, Teikyo University Chiba Medical Center
Kimikazu Matsumoto
Department of Children’s Cancer Center, National Center for Child Health and Development
Takashi Taga
Department of Pediatrics, Shiga University of Medical Science Hospital
Arata Watanabe
Department of Pediatrics, Nakadori General Hospital
Junko Takita
Deparment of Pediatrics, The University of Tokyo Hospital
Deparment of Pediatrics, Kyoto University Hospital
Keiko Nomura
Department of Pediatrics, Toyama University Hospital
Hirokazu Kanegane
Department of Pediatrics, Toyama University Hospital
Department of Pediatrics and Developmental Biology, Tokyo Medical And Dental University Hospital
Motoaki Chin
Department of Pediatrics and Child Health, Nihon University Itabashi Hospital
Akira Hayakawa
Department of Pediatrics, Kobe University Hospital
Department of Palliative Medicine, Yodogawa Christian Hospital
Takashi Fukushima
Department of Pediatrics, University of Tsukuba Hospital
Department of Pediatric Oncology, Saitama Medical University International Medical Center
Miho Kato
Department of Pediatric Hematology/Oncology, Nanbu Medical Center /Nanbu Child Medical Center
Hitoshi Dairoku
NPO LD/Dyslexia Center

Keywords: childhood acute lymphoblastic leukemia, neurocognitive performance, WISC-IV, working memory

JOURNAL FREE ACCESS

2021 Volume 58 Issue 5 Pages 424-431

DOI https://ntrd-jsjc-gov-cn-s-1416.res.gxlib.org.cn:443/rwt/1416/https/MSYXTLUQPJUB/10.11412/jspho.58.424

Details

Abstract

High-dose intravenous methotrexate (HD-MTX) and intrathecal MTX can cause long-term neurotoxicity that adversely affects intellectual function. We report the final results of a three-year longitudinal study of cognitive function of patients from 23 institutions. Data were collected from children diagnosed as having standard-risk acute lymphoblastic leukemia (ALL) between 2011 and 2016. A total of 57 patients aged three to nine years at the time of diagnosis were consecutively enrolled and the results of 43 were statistically analyzed. We used the Wechsler Intelligence Scale for Children-4^th Edition (WISC-IV) to obtain the scores for full-scale IQ (FSIQ), verbal comprehension index (VCI), perceptual reasoning index (PRI), working memory index (WMI), and processing speed index (PSI). The cognitive function of participants was tested using WISC-IV before and three times after the completion of HD-MTX therapy over three years. The four indices (VCI, PRI, WMI, and PSI) were statistically compared across four time points using ANOVA. Mean FSIQ scores were 99.09 (SD=14.72), 99.26 (SD=15.01), 102.30 (SD=11.08), and 101.12 (SD=11.69) at the four time points, respectively. Scores of Verbal Comprehension at TIME 1 were the lowest, whereas those of Working Memory were the lowest after TIME 2. These results should be verified with respect to daily life problems encountered by the patients.

Corresponding author

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