P300 Abnormalities in Long-Time Survivors of Acute Lymphoblastic Leukemia in Childhood - Side Effects of CNS Prophylaxis?

Abstract

The incidence and the degree of P300 abnormalities in relation to psychometric findings was assessed in two groups of long-term survivors of acute lymphoblastic leukemia (ALL) in childhood. The study was performed as part of a follow-up trial, evaluating CNS late-effects after antileukemic therapy, 7.1 ± 1.6 years after cessation of antileukemic therapy. Subject groups differed primarily in terms of antileukemic CNS prophylaxis: combined radio-and chemotherapy (n = 8) vs. chemotherapy alone (n = 5). Results were compared with those of a third group of healthy controls (n = 13) matched for age and gender. P300 recordings were obtained during a visual oddball-paradigm using checkerboard reversal stimuli of different pattern sizes as target and background events. Neurophysiological data were correlated with the results of a psychological test battery, which measured general intelligence, non-verbal visual memory functioning and concentration. ERP analysis showed a significant prolongation of the P300 latency in irradiated subjects when compared to healthy controls and non-irradiated long-term survivors. Topographical data comparisons revealed substantial P300 differences in both ALL long-term survivor groups when compared with healthy controls. This demonstrated significantly lower amplitudes over the left frontal derivations, associated with lowered concentration abilities, in the irradiated subject group. Higher amplitudes over the parieto-temporal derivations of the right hemisphere, associated with significantly impaired visual memory capabilities, were seen in both long-term survivor groups.

Key words

Children - Acute lymphoblastic leukemia - Antileukemic therapy - CNS late-effects - P300