This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (80)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Riccardo Haupt, MD; Thomas R. Fears, PhD; Leslie L. Robison, PhD; James L. Mills, MD; H. Stacy Nicholson, MD; Lonnie K. Zeltzer, MD; Anna T. Meadows, MD; Julianne Byrne, PhD

JAMA. 1994;272(18):1427-1432.

Abstract
Objective.
—To determine the impact of treatment on scholastic performance in the first cohort of survivors of childhood acute lymphoblastic leukemia who are old enough to have completed their educational experience.

Design.
—Retrospective cohort study.

Setting.
—Twenty-three institutions in the Childrens Cancer Group.

Subjects.
—A total of 593 adult survivors of childhood acute lymphoblastic leukemia and 409 sibling controls.

Outcome Measures.
—Enrollment in special programs, grades during high school, graduation from high school, college admission, and college graduation.

Results.
—After diagnosis, survivors were more likely than their sibling controls to enter a special education (relative risk [RR] =3.4; P<.01) or a learning disabled (RR=3.6; P<.01 ) program, while just as likely to enter gifted and talented programs (RR=1.0). The risk associated with special education and learning disabled programs increased with increasing dose of cranial radiotherapy. Despite these problems, survivors generally had the same probability as their siblings of finishing high school, entering college, and earning a bachelor's degree. However, survivors treated with 24 Gy and those diagnosed before 6 years of age were less likely to enter college (RR=0.67 and 0.6, respectively; P<.01).

Conclusions.
—This large study demonstrates that childhood acute lymphoblastic leukemia survivors have a greater likelihood of being placed in special education or learning disabled programs than their siblings, but that most are able to overcome these problems. Dose of cranial radiotherapy and age at diagnosis are the most important education-related risk factors.

(JAMA. 1994;272:1427-1432)

Author Affiliations
From the Clinical Epidemiology Branch (Drs Haupt and Nicholson) and Biostatistics Branch (Dr Fears) of the National Cancer Institute, and Epidemiology Branch of the National Institute of Child Health and Human Development (Dr Mills), National Institutes of Health, Bethesda, Md; the Department of Hematology/ Oncology, Children's National Medical Center, Washington, DC (Drs Nicholson and Byrne); the Children's Hospital of Philadelphia (Pa) (Dr Meadows); the Department of Pediatrics, University of Minnesota, Minneapolis (Dr Robison); and the Department of Pediatrics, UCLA Medical Center, Los Angeles, Calif (Dr Zeltzer). Dr Haupt is now with the Department of Pediatric Hematology/Oncology, G. Gaslini Children's Hospital, Genoa, Italy.

Footnotes
The studies described in this article were presented in part at the 29th annual meeting of the American Society of Clinical Oncology, Orlando, Fla, May 16-18, 1993.

Reprint requests to Department of Pediatric Hematology/Oncology, G. Gaslini Children's Hospital, Largo G. Gaslini 5, 16147 Genoa, Italy (Dr Haupt).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Predicting Methylphenidate Response in Long-Term Survivors of Childhood Cancer: A Randomized, Double-Blind, Placebo-Controlled, Crossover Trial
Conklin et al.
J Pediatr Psychol 2009;0:jsp044v1-jsp044.
ABSTRACT | FULL TEXT  

Social Outcomes in the Childhood Cancer Survivor Study Cohort
Gurney et al.
JCO 2009;27:2390-2395.
ABSTRACT | FULL TEXT  

Radioprotection
GREENBERGER
In Vivo 2009;23:323-336.
ABSTRACT | FULL TEXT  

Long-Term Smoking Cessation Outcomes Among Childhood Cancer Survivors in the Partnership for Health Study
Emmons et al.
JCO 2009;27:52-60.
ABSTRACT | FULL TEXT  

Successful Coordination and Execution of Nontherapeutic Studies in a Cooperative Group Setting: Lessons Learned from Children's Oncology Group Studies
Carter et al.
Cancer Epidemiol. Biomarkers Prev. 2008;17:1665-1673.
ABSTRACT | FULL TEXT  

Neurocognitive Impairment in Children Treated for Cancer: How Do We Measure Cognitive Outcomes?
Gross-King et al.
Journal of Pediatric Oncology Nursing 2008;25:227-232.
ABSTRACT  

Twenty-five-year follow-up among survivors of childhood acute lymphoblastic leukemia: a report from the Childhood Cancer Survivor Study
Mody et al.
Blood 2008;111:5515-5523.
ABSTRACT | FULL TEXT  

Acute Neurocognitive Response to Methylphenidate Among Survivors of Childhood Cancer: A Randomized, Double-Blind, Cross-Over Trial
Conklin et al.
J Pediatr Psychol 2007;32:1127-1139.
ABSTRACT | FULL TEXT  

Beyond Survival: Quality of Life and Follow-up After Childhood Cancer
Eiser
J Pediatr Psychol 2007;32:1140-1150.
ABSTRACT | FULL TEXT  

Scholastic Achievements of Childhood Leukemia Patients: A Nationwide, Register-Based Study
Harila-Saari et al.
JCO 2007;25:3518-3524.
ABSTRACT | FULL TEXT  

Peer-Delivered Smoking Counseling for Childhood Cancer Survivors Increases Rate of Cessation: The Partnership for Health Study
Emmons et al.
JCO 2005;23:6516-6523.
ABSTRACT | FULL TEXT  

International Comparison of Contributions to Psychosocial Research on Survivors of Childhood Cancer: Past and Future Considerations
Last et al.
J Pediatr Psychol 2005;30:99-113.
ABSTRACT | FULL TEXT  

Long-term Complications Following Childhood and Adolescent Cancer: Foundations for Providing Risk-based Health Care for Survivors
Oeffinger and Hudson
CA Cancer J Clin 2004;54:208-236.
ABSTRACT | FULL TEXT  

Impact of CNS Treatment on Mood in Adult Survivors of Childhood Leukemia: A Report From the Children's Cancer Group
Glover et al.
JCO 2003;21:4395-4401.
ABSTRACT | FULL TEXT  

Extended Follow-up of Long-Term Survivors of Childhood Acute Lymphoblastic Leukemia
Pui et al.
NEJM 2003;349:640-649.
ABSTRACT | FULL TEXT  

Cancer Survivorship Research: Challenge and Opportunity
Aziz
J. Nutr. 2002;132:3494S-3503.
ABSTRACT | FULL TEXT  

Psychological Outcomes in Long-Term Survivors of Childhood Leukemia, Hodgkin's Disease, and Non-Hodgkin's Lymphoma: A Report From the Childhood Cancer Survivor Study
Zebrack et al.
Pediatrics 2002;110:42-52.
ABSTRACT | FULL TEXT  

Immediate Neurocognitive Effects of Methylphenidate on Learning-Impaired Survivors of Childhood Cancer
Thompson et al.
JCO 2001;19:1802-1808.
ABSTRACT | FULL TEXT  

Long-Term Survivors of Childhood Cancer: The Late Effects of Therapy
Schwartz
The Oncologist 1999;4:45-54.
ABSTRACT | FULL TEXT  

Young Adult Survivors of Childhood Cancer: Attending to Emerging Medical and Psychosocial Needs
Richardson et al.
Journal of Pediatric Oncology Nursing 1999;16:136-144.
ABSTRACT  

Pathways Linking Treatment Intensity and Psychosocial Outcomes among Adult Survivors of Childhood Leukemia
Chen et al.
J Health Psychol 1998;3:23-38.
ABSTRACT  

Educational Attainment in Survivors of ALL
Challinor and Karl
JAMA 1995;274:1134-1134.
ABSTRACT  

Childhood Leukemias
Pui
NEJM 1995;332:1618-1630.
FULL TEXT  

Central Nervous System Toxicity of Cancer Therapy in Children
Moore
Journal of Pediatric Oncology Nursing 1995;12:203-210.
ABSTRACT