Abstract：
BACKGROUND: Cognitive dysfunction may be one of the hazardous late effects among survivors of pediatric hematological malignancies. Our study aimed to explore cognitive performance and assess the global and regional brain volume changes in survivors of hematological malignancies.
METHODS: This case-control study was conducted on 68 survivors of hematological malignancies, with a median follow-up period of 2 years (ranging from 1 to 6.2 years). Stanford-Binet Test was used for cognitive assessment. A quantitative volumetric assessment of the brain was done using the NeuroQuant Brain Magnetic Resonance. Age and sex-matched 68 children were selected as a comparison group.
RESULTS: Cancer survivors showed significantly lower levels of IQ and their subtests than the control group. Global brain atrophy was observed in the majority of the survivors. Many risk factors significantly affected different IQ subtests, such as radiotherapy (RTH), high cumulative doses of methotrexate (MTX), and prednisone. At the same time, low white matter volume (WMV) was observed with higher cumulative doses of MTX and anthracyclines.
CONCLUSIONS: Hematological malignancies have a negative impact on cognition. Neurocognitive impairment and related brain changes were evident in those who received RTH, HDMTX, or high cumulative doses of steroids.
METHODS: This case-control study was conducted on 68 survivors of hematological malignancies, with a median follow-up period of 2 years (ranging from 1 to 6.2 years). Stanford-Binet Test was used for cognitive assessment. A quantitative volumetric assessment of the brain was done using the NeuroQuant Brain Magnetic Resonance. Age and sex-matched 68 children were selected as a comparison group.
RESULTS: Cancer survivors showed significantly lower levels of IQ and their subtests than the control group. Global brain atrophy was observed in the majority of the survivors. Many risk factors significantly affected different IQ subtests, such as radiotherapy (RTH), high cumulative doses of methotrexate (MTX), and prednisone. At the same time, low white matter volume (WMV) was observed with higher cumulative doses of MTX and anthracyclines.
CONCLUSIONS: Hematological malignancies have a negative impact on cognition. Neurocognitive impairment and related brain changes were evident in those who received RTH, HDMTX, or high cumulative doses of steroids.
摘要：
背景：认知功能障碍可能是儿科恶性血液病幸存者的危险晚期影响之一。我们的研究旨在探索认知表现并评估血液系统恶性肿瘤幸存者的整体和区域脑体积变化。
方法：这项病例对照研究是对68例血液系统恶性肿瘤幸存者进行的，中位随访期为2年（1至6.2年）。斯坦福-比奈测验用于认知评估。使用NeuroQuant脑磁共振进行脑的定量体积评估。选择年龄和性别匹配的68名儿童作为对照组。
结果：癌症幸存者的智商水平和他们的亚测试水平明显低于对照组。在大多数幸存者中观察到整体脑萎缩。许多危险因素显著影响不同的智商子测试，如放射治疗（RTH），高累积剂量的甲氨蝶呤（MTX），和泼尼松。同时,使用较高累积剂量的MTX和蒽环类药物观察到低白质体积（WMV）。
结论：血液恶性肿瘤对认知有负面影响。在接受RTH的患者中，神经认知障碍和相关的大脑变化很明显，HDMTX,或高累积剂量的类固醇.
方法：这项病例对照研究是对68例血液系统恶性肿瘤幸存者进行的，中位随访期为2年（1至6.2年）。斯坦福-比奈测验用于认知评估。使用NeuroQuant脑磁共振进行脑的定量体积评估。选择年龄和性别匹配的68名儿童作为对照组。
结果：癌症幸存者的智商水平和他们的亚测试水平明显低于对照组。在大多数幸存者中观察到整体脑萎缩。许多危险因素显著影响不同的智商子测试，如放射治疗（RTH），高累积剂量的甲氨蝶呤（MTX），和泼尼松。同时,使用较高累积剂量的MTX和蒽环类药物观察到低白质体积（WMV）。
结论：血液恶性肿瘤对认知有负面影响。在接受RTH的患者中，神经认知障碍和相关的大脑变化很明显，HDMTX,或高累积剂量的类固醇.
