Neurocognitive deficits seen in survivors of pediatric Hodgkin's
To evaluate neurocognitive and brain imaging outcomes in adult survivors of childhood Hodgkin's lymphoma, Kevin R. Krull, Ph.D., of the St. Jude Children's Research Hospital in Memphis, Tenn., and colleagues conducted a study involving 62 adult survivors who had been treated with either high- or low-dose thoracic radiation plus anthracycline.
The researchers found that Hodgkin's lymphoma survivors had significantly lower performance on tests of sustained attention, short- and long-term memory, working memory, naming speed, and cognitive fluency, compared with national age-adjusted norms. Fifty-three percent had leukoencephalopathy and 37 percent displayed evidence of cerebrovascular injury on magnetic resonance imaging. High-dose thoracic radiation was significantly associated with impaired cardiac diastolic and pulmonary function and leukoencephalopathy, compared to low-dose radiation. Working memory impairment correlated with cardiac diastolic function, while impaired sustained attention and naming speed correlated with pulmonary function. There was a correlation between neurocognitive performance and academic and vocational functioning.
"These results suggest that adult long-term survivors of childhood Hodgkin's lymphoma are at risk for neurocognitive impairment, which is associated with radiologic indices suggestive of reduced brain integrity and which occurs in the presence of symptoms of cardiopulmonary dysfunction," Krull and colleagues conclude.
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