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Comparative Study
. 2003 Dec 1;21(23):4395-401.
doi: 10.1200/JCO.2003.04.089.

Impact of CNS treatment on mood in adult survivors of childhood leukemia: a report from the Children's Cancer Group

Dorie A Glover  1 , Julianne Byrne, James L Mills, Leslie L Robison, H Stacy Nicholson, Anna Meadows, Lonnie K Zeltzer; Children's Cancer Group
Affiliations
Comparative Study

Impact of CNS treatment on mood in adult survivors of childhood leukemia: a report from the Children's Cancer Group

Dorie A Glover et al. J Clin Oncol. .

Abstract

Purpose: This study assessed the relationship between CNS treatment and psychologic mood using the Profile of Moods State (POMS), a standardized measure of affect, among a large sample of young adult survivors of childhood acute lymphoblastic leukemia (ALL; N = 555).

Patients and methods: Survivors of childhood ALL (ages 18 to 33 years at study entry) participated in a structured telephone interview eliciting demographic, health, and behavioral data and the POMS. Treatment data included total dose of CNS irradiation (CRT) and intrathecal methotrexate (MTX) obtained from medical records.

Results: Mood disturbance was reported by 24% of survivors. High-dose CRT and MTX predicted disturbance rates modestly and primarily in combination with education variables. Interactions between educational achievement, a history of attendance in special education classes, and sex were better predictors than treatment type or dose. Nonwhite males, those younger than 12.5 years of age at diagnosis, and those with negative perceptions of current health and cancer's impact on employment were also at greater risk for mood disturbance (P <.01 to.001).

Conclusion: Although most survivors are doing well psychologically, a subset of long-term survivors show potentially serious mood disturbance. Mood disturbance seems to be a function of interactions between preexisting individual difference variables (eg, sex, race/ethnicity), treatment factors, and posttreatment educational experiences. Prevention strategies aimed at childhood cancer survivors at greatest risk for mood disturbance may be improved by focus on posttreatment psychosocial and educational supports.

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Conflict of interest statement

AUTHORS’ DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

The authors indicated no potential conflicts of interest.

Figures

Fig 1
Fig 1
Risk of mood disturbance as a function of treatment and highest education achieved. MTX, methotrexate; CRT, cranial radiation treatment; hs, high school, grad, graduate.
Fig 2
Fig 2
Risk of mood disturbance as a function of special education history and highest education achieved. HS, high school; spec ed, special education.
See this image and copyright information in PMC

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