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. 2025 Mar;27(3):1263-1273.
doi: 10.1007/s12094-024-03646-7. Epub 2024 Aug 12.

Cognitive performance and brain volume among survivors of pediatric hematological malignancies: a case-control study

Amira M Osman  1 , Amany M Ali  1 , Heba A Sayed  1 , Haisam Atta  2 , Shimaa Ahmed  3 , Nelly Alieldin  4 , Mohamed A Abdelhamed  5 , Khaled Saad  6 , Azza Shibl  1
Affiliations

Cognitive performance and brain volume among survivors of pediatric hematological malignancies: a case-control study

Amira M Osman et al. Clin Transl Oncol. 2025 Mar.

Abstract

Background: Cognitive dysfunction may be one of the hazardous late effects among survivors of pediatric hematological malignancies. Our study aimed to explore cognitive performance and assess the global and regional brain volume changes in survivors of hematological malignancies.

Methods: This case-control study was conducted on 68 survivors of hematological malignancies, with a median follow-up period of 2 years (ranging from 1 to 6.2 years). Stanford-Binet Test was used for cognitive assessment. A quantitative volumetric assessment of the brain was done using the NeuroQuant Brain Magnetic Resonance. Age and sex-matched 68 children were selected as a comparison group.

Results: Cancer survivors showed significantly lower levels of IQ and their subtests than the control group. Global brain atrophy was observed in the majority of the survivors. Many risk factors significantly affected different IQ subtests, such as radiotherapy (RTH), high cumulative doses of methotrexate (MTX), and prednisone. At the same time, low white matter volume (WMV) was observed with higher cumulative doses of MTX and anthracyclines.

Conclusions: Hematological malignancies have a negative impact on cognition. Neurocognitive impairment and related brain changes were evident in those who received RTH, HDMTX, or high cumulative doses of steroids.

Keywords: Hematological malignancies; NeuroQuant MRI; Neurocognitive; Pediatrics; Volumetric assessment.

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Conflict of interest statement

Declarations. Conflict of interests: The authors declare no competing interests. Ethical approval: Our study's protocols and investigations followed the regulations of the research ethics committee of Assiut University. Consent for participate: All caregivers of all participants have given their informed written consent.

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