Neuropathic pain and neurocognitive functioning in children treated for acute lymphoblastic leukemia.
Abstract: Children with acute lymphoblastic leukemia (ALL) often experience treatment-related neurocognitive deficits and significant pain. Pain may exacerbate these cognitive impairments. This study examined neuropathic pain and neurocognitive outcomes in survivors of childhood ALL treated with con...
| Published in: | PAIN Vol. 163; no. 6; pp. 1070 - 1078 |
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| Main Authors: | , , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Lippincott Williams & Wilkins
Jun2022
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=156837647&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 156837647 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03043959 22N jtl: PAIN issn: 03043959 maglogo: N pubinfo: dt: Jun2022 vid: 163 iid: 6 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 156837647 156837647 NLM34813516 156837647 10.1097/j.pain.0000000000002485 NLM34813516 156837647 ppf: 1070 ppct: 8 formats: tig: atl: Neuropathic pain and neurocognitive functioning in children treated for acute lymphoblastic leukemia. aug: au: Partanen, Marita Alberts, Nicole M. Conklin, Heather M. Krull, Kevin R. Pui, Ching-Hon Anghelescu, Doralina A. Jacola, Lisa M. affil: Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands sug: subj: Leukemia, Lymphocytic, Acute Psychosocial Factors Leukemia, Lymphocytic, Acute Drug Therapy Neuralgia Leukemia, Lymphocytic, Acute Complications Child Female Neuropsychological Tests Analgesics, Opioid Adverse Effects Male Human Funding Source Child: 6-12 years Female Male ab: Abstract: Children with acute lymphoblastic leukemia (ALL) often experience treatment-related neurocognitive deficits and significant pain. Pain may exacerbate these cognitive impairments. This study examined neuropathic pain and neurocognitive outcomes in survivors of childhood ALL treated with contemporary therapy on a clinical trial (NCT00137111). There were 345 survivors (45% female, M = 6.9 years at diagnosis) who completed neurocognitive assessments including measures of sustained attention, learning and memory, and parent ratings of attention during at least one of 4 time points: on-therapy (Induction and Reinduction), end of therapy, and 2 years post-therapy. At-risk performance was defined as a score at least 1SD below the age-adjusted mean. Data on neuropathic pain (events, duration, and severity according NCI Common Toxicity Criteria) and pharmacologic pain management (opioids and gabapentin) were ascertained. Results showed that 135 survivors (39%) experienced neuropathic pain during treatment. Compared with those without pain, survivors with pain had greater memory impairments at end of therapy (California Verbal Learning Test [CVLT]-Total, 24% vs 12%, P = 0.046). Within the pain group, survivors who experienced a greater number of pain events (CVLT-Total = -0.88, P = 0.023) and those who were treated with opioids (versus gabapentin) had poorer learning and memory performance (CVLT-Total = -0.73, P = 0.011; Short Delay = -0.57, P = 0.024; Long Delay = -0.62, P = 0.012; and Learning Slope = -0.45, P = 0.042) across time points. These are considered medium-to-large effects (SD = 0.45-0.88). Neuropathic pain may be a risk factor for learning problems after therapy completion, and treatment for pain with opioids may also adversely affect neurocognitive performance. Therefore, patients who experience pain may require closer monitoring and additional intervention for neurocognitive impairment. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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