Baseline neurocognitive functioning among children treated for acute lymphoblastic leukemia (ALL): Dana Farber Cancer Institute ALL consortium study 16-001 Journal Article


Authors: Ramjan, S.; Thies, M. B.; Li, Y.; Thrope, A.; Silverman, L.; Welch, J. J. G.; Kahn, J.; Kelly, K. M.; Tran, T. H.; Michon, B.; Gennarini, L.; Bona, K.; Park, Y.; Cole, P. D.; Sands, S. A.
Article Title: Baseline neurocognitive functioning among children treated for acute lymphoblastic leukemia (ALL): Dana Farber Cancer Institute ALL consortium study 16-001
Abstract: Background: This study describes neurocognitive functioning during the first month of induction chemotherapy for childhood acute lymphoblastic leukemia (ALL) and associations with age, sex, risk of relapse, maternal education, household material hardship (HMH), and oxidative stress. Methods: Patients treated on protocol 16-001 (NCT03020030) across eight North American sites (2017–2022) consented for optional testing using Cogstate at six timepoints throughout treatment. The baseline data presented were collected within the first month after diagnosis. Results: Among 406 eligible patients, 330 (81%) consented (53% males, mean age = 8.8 years, SD = 4.7). Over 63% of participants performed within normal limits for their age range. Additionally, no relationship was observed at baseline between neurocognition and maternal education, HMH, or oxidative stress. In contrast, a linear relationship was observed between older age and weaker psychomotor speed (p < 0.0001), attention (p < 0.0001), and working memory (p = 0.019). Males also demonstrated faster psychomotor speed (p = 0.0027), while females demonstrated stronger visual learning (p = 0.011). Furthermore, having a higher risk of relapse was associated with slower psychomotor speed (p = 0.006) and weaker attention (p = 0.033). Conclusions: Our findings indicate that most ALL patients in this study who were assessed at baseline did not display cognitive impairments, except for a small subset of participants who were below age expectations across domains. These baseline findings also identify subgroups based upon age, sex, and ALL risk classification that begin medical treatment with neurocognitive delays, warranting monitoring to elucidate whether exposure to therapy further impacts these domains. Additionally, the lack of impact on neurocognitive functioning at baseline of maternal education, HMH, and/or oxidative stress enables subsequent assessments to effectively identify the potential emergence of deficits as a result of exposure to medical treatment. © 2025 Wiley Periodicals LLC.
Keywords: acute lymphoblastic leukemia; cognition
Journal Title: Pediatric Blood and Cancer
Volume: 72
Issue: 8
ISSN: 1545-5009
Publisher: Wiley Periodicals, Inc  
Publication status: Published
Date Published: 2025-08-01
Start Page: e31767
Language: English
DOI: 10.1002/pbc.31767
PROVIDER: scopus
PMCID: PMC12187539
PUBMED: 40361276
DOI/URL:
Notes: Source: Scopus
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MSK Authors
  1. Yuelin Li
    224 Li
  2. Stephen Alan Sands
    25 Sands
  3. Sameera Afzaa Ramjan
    12 Ramjan
  4. Alexandra Paige Thrope
    2 Thrope
  5. Melanie Thies
    4 Thies