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Supportive Care in Cancer
Published in: Supportive Care in Cancer 2/2017

01-02-2017 | Original Article

Feasibility of baseline neurocognitive assessment using Cogstate during the first month of therapy for childhood leukemia

Authors: Stephen A. Sands, Brian T. Harel, Mirko Savone, Kara Kelly, Veena Vijayanathan, Jennifer Greene Welch, Lynda Vrooman, Lewis B. Silverman, Peter D. Cole

Published in: Supportive Care in Cancer | Issue 2/2017

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Abstract

Purpose

Neurocognitive impairment is frequently observed among acute lymphoblastic leukemia (ALL) survivors within the domains of intelligence, attention, processing speed, working memory, learning, and memory. However, few have investigated treatment-induced changes in neurocognitive function during the first months of treatment. Additionally, dysfunction during treatment may be preceded by changes in biomarkers measured within cerebrospinal fluid (CSF). Identification of acute declines in neurocognitive function, as well as predictive genotypes or biomarkers, could guide therapeutic trials of protective interventions.

Methods

This study collects CSF while prospectively assessing neurocognitive functioning (working memory, executive function, learning, processing speed, and attention) of ALL patients using the Cogstate computerized battery at six time points during and after the 2 years of leukemia treatment on a Dana-Farber Cancer Institute ALL Consortium trial.

Results

Baseline data collected during the first 3 weeks of induction chemotherapy indicate reliable data as all subjects (N = 34) completed Cogstate baseline testing, while completion and performance checks indicate that 100 % of subjects completed testing and complied with test requirements. The majority (85 %) exhibited normal function compared with age peers. Preliminary analysis of CSF biomarkers (folate, homocysteine, 8-isoprostane, and myelin basic protein) similarly reveals values at baseline within expected normal ranges.

Conclusions

The first month of induction therapy for ALL is a reliable baseline for detecting treatment-induced changes in neurocognitive functioning. Consequently, serial data collection might identify subgroups of ALL patients at increased risk for neurocognitive decline, warranting proactive interventions to improve their level of functioning both during treatment and into survivorship.
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Metadata
Title
Feasibility of baseline neurocognitive assessment using Cogstate during the first month of therapy for childhood leukemia
Authors
Stephen A. Sands
Brian T. Harel
Mirko Savone
Kara Kelly
Veena Vijayanathan
Jennifer Greene Welch
Lynda Vrooman
Lewis B. Silverman
Peter D. Cole
Publication date
01-02-2017
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 2/2017
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-016-3422-9

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