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Smaller-sized brain structure observed in adult survivors of ALL
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Adult survivors of childhood acute lymphoblastic leukemia had smaller-sized neuroanatomic structures than healthy controls, and the differences were noticeable decades after treatment, according to study results.
Still, most of the ALL survivors had functioning IQs similar to healthy controls, researchers reported.
“ALL survivors showed significantly smaller volumes of cortical gray matter, cerebral white matter, amygdala, caudate, hippocampus, thalamus and estimated intracranial volume,” the researchers wrote.
The investigators diagnosed regional brain volumes in 130 adult long-term survivors of childhood ALL diagnosed between 1970 and 2002. MRI and neuropsychological testing took place a median of 22.5 years after diagnosis. The researchers compared these findings with data from 130 healthy adult controls.
Median age for ALL survivors was 28.4 years at study initiation; 18 patients received cranial radiation therapy and were therefore excluded from the study.
Neither age at diagnosis nor treatment variables had a significant impact on neuroanatomic volumes, the researchers said.
Researchers observed reductions in processing speed, executive function and verbal learning and memory skills in ALL survivors. However, no differences were observed in estimated general intellectual ability between controls and survivors.
The most significant difference was a 5.2% smaller caudate in ALL survivors; these volumes were smaller when researchers controlled for intracranial volume.
To correct for individual differences in total brain size, ANCOVA tests were performed on residual volumes after correcting for intracranial volume. Researchers continued to see a significantly smaller caudate volume among ALL survivors (Z-score difference=0.0334; P=.007).
When the researchers compared a subgroup of 108 ALL survivors with 108 healthy controls with the same years of education, they found similar volume differences.
“Because of possible selection biases, these results must be interpreted with caution,” the researchers wrote. “Future studies are required to clarify the significance of these findings and the neurobiologic mechanisms involved.”
Disclosure: The researchers report no relevant financial disclosures.
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