Accelerated aging, decreased white matter integrity, and associated neuropsychological dysfunction 25 years after pediatric lymphoid malignancies
| Autor: | Sabine Deprez, Wim Van Hecke, Cor van den Bos, Eline van Dulmen-den Broeder, Frederik Barkhof, Leo M. J. de Sonneville, Helena J H van der Pal, Anne Uyttebroeck, Marita Daams, Stefan Sunaert, Anjo J.P. Veerman, Ilse Schuitema |
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| Přispěvatelé: | CCA -Cancer Center Amsterdam, APH - Amsterdam Public Health, Paediatric Oncology, Pediatric surgery, Radiology and nuclear medicine, CCA - Innovative therapy |
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Cancer Research Pathology medicine.medical_specialty Adolescent Lymphoma Neuropsychological Tests Nerve Fibers Myelinated White matter Young Adult Fractional anisotropy medicine Humans Survivors Young adult Childhood Acute Lymphoblastic Leukemia business.industry Neuropsychology Case-control study Brain Chemoradiotherapy Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease medicine.anatomical_structure Diffusion Magnetic Resonance Imaging Oncology Case-Control Studies Female business |
| Zdroj: | Journal of clinical oncology, 31(27), 3378-3388. American Society of Clinical Oncology Scopus-Elsevier Journal of Clinical Oncology, 31(27), 3378-3388. American Society of Clinical Oncology Schuitema, I, Deprez, S, van Hecke, W, Daams, M, Uyttebroeck, A, Sunaert, S, Barkhof, F, van Dulmen-den Broeder, E, van der Pal, H J, Bos, C, Veerman, A J & de Sonneville, L M 2013, ' Accelerated aging, decreased white matter integrity, and associated neuropsychological dysfunction 25 years after pediatric lymphoid malignancies ', Journal of Clinical Oncology, vol. 31, no. 27, pp. 3378-3388 . https://doi.org/10.1200/JCO.2012.46.7050 |
| ISSN: | 0732-183X |
| DOI: | 10.1200/jco.2012.46.7050 |
| Popis: | Purpose CNS-directed chemotherapy (CT) and cranial radiotherapy (CRT) for childhood acute lymphoblastic leukemia or lymphoma have various neurotoxic properties. This study aimed to assess their impact on the maturing brain 20 to 30 years after diagnosis, providing a much stronger perspective on long-term quality of life than previous studies. Patients and Methods Ninety-three patients treated between 1978 and 1990 at various intensities, with and without CRT, and 49 healthy controls were assessed with magnetic resonance diffusion tensor imaging (DTI) and neuropsychological tests. Differences in fractional anisotropy (FA)—a DTI measure describing white matter (WM) microstructure—were analyzed by using whole brain voxel-based analysis. Results CRT-treated survivors demonstrated significantly decreased FA compared with controls in frontal, parietal, and temporal WM tracts. Trends for lower FA were seen in the CT-treated survivors. Decreases in FA correlated well with neuropsychological dysfunction. In contrast to the CT group and controls, the CRT group showed a steep decline of FA with age at assessment. Younger age at cranial irradiation and higher dosage were associated with worse outcome of WM integrity. Conclusion CRT-treated survivors show decreased WM integrity reflected by significantly decreased FA and associated neuropsychological dysfunction 25 years after treatment, although effects of CT alone seem mild. Accelerated aging of the brain and increased risk of early onset dementia are suspected after CRT, but not after CT. |
| Databáze: | OpenAIRE |
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