A Neuropsychological Outcomes among Survivors of Childhood Acute Lymphoblastic Leukaemia in Malaysia

Abstract

Abstract The 5-year survival rate of childhood acute lymphoblastic leukaemia (ALL) in Malaysia is between 80% and 90%. This study intended to explore the neuropsychological ramifications in childhood ALL survivors in Malaysia and to examine treatment-related sequelae. A case-control study was conducted over a 2-year period. Seventy-one survivors of childhood ALL who have completed treatment for a minimum of 1 year and were in remission, and 71 healthy volunteers were enlisted. To assess alertness (processing speed) and essential executive functioning skills such as working memory capacity, inhibition, cognitive flexibility, and sustained attention, seven measures from the Amsterdam Neuropsychological Tasks (ANT) programme were chosen. Main outcome measures were speed, stability and accuracy of responses. Mean age at diagnosis was 4.50 years (SD ± 2.40) while mean age at study entry was 12.18 years (SD ± 3.14). Except for alertness, survivors of childhood ALL underperformed on 6 out of 7 ANT tasks, indicating poorer sustained attention, working memory capacity, executive visuomotor control, and cognitive flexibility. None of the treatment parameters like duration of treatment, age at diagnosis, gender, or cumulative doses of chemotherapy were correlated with any of the neuropsychological outcome measures. Childhood ALL survivors in our facility demonstrated significantly poorer neuropsychological status compared to healthy controls.