Neuropsychological Performance and Its Predictors in the Early Treatment Phase of Non-CNS Pediatric Cancer

BACKGROUND: Pediatric cancer survivors can experience neuropsychological problems in the long term. Less is known about neuropsychological performance and its possible predictors in the early treatment phase of non-central nervous system (CNS) cancers.

PROCEDURE: This study describes the neuropsychological performance of 104 children with leukemia (n = 43), lymphoma (n = 29), or a non-CNS solid tumor (n = 33) aged 5-18 years at diagnosis (M = 11.78, SD = 3.71, 48% female), 4.52 months (SD = 0.77) after diagnosis. Using one-sample t-tests, measures of IQ, attention, memory, working memory, verbal fluency, processing speed, and reading were compared to age-matched norm scores. Individual comparisons were performed with paired t-tests, comparing participants' neuropsychological scores to their estimated IQ (EIQ). Multiple regression analyses related medical factors, pre-existing developmental vulnerabilities, and family psychosocial risk to neuropsychological outcomes, corrected for age at diagnosis, sex, and EIQ.

RESULTS: EIQ was significantly above the population mean (M = 105.25, SD = 12.15, p < 0.05), and most neuropsychological outcomes were within the average range compared to age-matched norms. Compared to their EIQ, however, participants' scores were on average significantly lower for almost all neuropsychological outcomes (p < 0.05). Medical factors, developmental vulnerabilities, and family psychosocial risk were not associated with neuropsychological outcomes (p > 0.05) in multivariable models. In a follow-up analysis, family psychosocial risk was related to memory (p < 0.05).

CONCLUSIONS: Children with non-CNS cancers perform within the average range on most neuropsychological tests. However, most scores are lower than participants' EIQ, revealing potential vulnerabilities. Family psychosocial risk may relate to memory. Future studies should include longitudinal follow-up and alternative predictors to clarify what contributes to early neuropsychological difficulties.