Dexamethasone exposure and memory function in adult survivors of childhood acute lymphoblastic leukemia: A report from the SJLIFE cohort1. Issue 11 (18th June 2013)

• Record Type: Journal Article
• Authors: Edelmann, Michelle N.; Ogg, Robert J.; Scoggins, Matthew A.; Brinkman, Tara M.; Sabin, Noah D.; Pui, Ching‐Hon; Srivastava, Deo Kumar; Robison, Leslie L.; Hudson, Melissa M.; Krull, Kevin R.
• Is Part Of: Pediatric blood & cancer. Volume 60:Issue 11(2013:Nov.)
• Page Start: 1778
• Page End: 1784
• Publication Date: 2013-06-18
• Subjects: Tumors in children -- Periodicals; Blood -- Diseases -- Periodicals; Cancer in children -- Periodicals; 618.92
• DOI: 10.1002/pbc.24644
• Languages: English
• ISSNs: 1545-5009

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="pbc24644-sec-0001" sec-type="section"> <title>Background</title> <p>Dexamethasone is used in acute lymphoblastic leukemia (ALL) treatment, though long‐term impact on central nervous system (CNS) function is unclear. As glucocorticoids influence hippocampal function, we investigated memory networks in survivors of childhood ALL treated with dexamethasone or prednisone.</p> </sec> <sec id="pbc24644-sec-0002" sec-type="section"> <title>Procedure</title> <p>Neurocognitive assessment and functional magnetic resonance imaging (fMRI) were conducted in 38 adult survivors randomly recruited from cohorts treated on one of two standard treatment protocols, which differed primarily in the glucocorticoid administered during continuation therapy (dexamethasone [n = 18] vs. prednisone [n = 20]). Groups did not differ in age at diagnosis, age at evaluation, or cumulative intravenous or intrathecal methotrexate exposure.</p> </sec> <sec id="pbc24644-sec-0003" sec-type="section"> <title>Results</title> <p>Survivors treated with dexamethasone demonstrated lower performance on multiple memory‐dependent measures, including story memory (<italic>P</italic> = 0.01) and word recognition (<italic>P</italic> = 0.04), compared to survivors treated with only prednisone. Dexamethasone treatment was associated with decreased fMRI activity in the left retrosplenial brain region (effect size = 1.3), though the small sample size limited statistical significance (<italic>P</italic> = 0.08). Story memory was associated with altered activation in left inferior frontal–temporal brain regions (<italic>P</italic> = 0.007).</p> </sec> <sec id="pbc24644-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Results from this pilot study suggest that adult survivors of ALL treated with dexamethasone are at increased risk for memory deficits and altered neural activity in specific brain regions and networks associated with memory function. Pediatr Blood Cancer 2013;60:1778–1784. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>