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| Vol. 23, No. 14 |
| August 1, 2001 |
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Study Addresses Learning Problems of Leukemia Patients By LORI WILLIAMS and DR. MARILYN HOCKENBERRY Baylor College of Medicine More and more children are surviving cancer, only to face another hurdle - learning disabilities caused by their life-saving treatment.
"Overall, there is a 75 percent survival rate for childhood leukemia. But some of these surviving children have learning deficits, particularly in math, as a result of their treatment," said Dr. Marilyn Hockenberry, professor of pediatric hematology and oncology at Baylor College of Medicine.
Although the number of children experiencing learning disabilities has been decreasing with improvements in therapy, some patients have experienced a significant decrease in IQ. These children have difficulties with attention, memory, executive function, visual-spatial activities, and performance.
"Although life-saving, some of our treatments have produced central nervous system damage," Dr. Hockenberry said.
To address this issue, researchers from Texas Children's Cancer Center in Houston and the University of Arizona in Tucson are working on two projects. In the first, they are trying to determine how treatment impacts learning and central nervous system development. A second project will test a math tutoring intervention program to determine if treatment-associated learning deficits can be lessened or prevented. This project is the first of its kind to evaluate a math intervention program for the prevention of learning difficulties in children with cancer.
Children participating in the math portion of the study will be randomly assigned to an intervention program consisting of weekly one-hour tutoring sessions, specifically designed to work on math skills, during their second year of therapy. The Key Math Teach and Practice curriculum will be used because it is based on skill and mastery development.
"Our goal is to determine whether individual attention to the learning process will minimize learning deficits in children with leukemia in the future," Dr. Hockenberry said.
The goal is to enroll 120 children at the two sites. The children, as well as their siblings when available, will be tracked over five years. The siblings will be followed to rule out genetic and environmental factors that can influence learning. The first patient will begin the math intervention tutoring program in September.
An important variable in this study is the evaluation of specific biologic markers in the spinal fluid of these children. Evaluation of these membrane-bound proteins may lead to an understanding of how chemotherapy damages the central nervous system, as well as determining who may be most at risk for learning difficulties. Spinal fluid will be collected during routine procedure visits. In addition, academic and cognitive function will be evaluated during the first three years of therapy.
"In the past, most learning deficits were diagnosed after leukemia treatment was completed following a long history of learning difficulties experienced by the child," Dr. Hockenberry said.
A future goal is to prevent academic problems, if possible, before they develop.
Principal investigators collaborating with Dr. Hockenberry on these projects are Drs. Kris Kaemingk and Ki Moore from the University of Arizona, and Dr. Kevin Krull from Baylor. The National Institutes of Health is funding the projects at the two institutions.
The Texas Children's Cancer Center and Hematology Service is a joint effort of Baylor College of Medicine and Texas Children's Hospital.
©2006 Texas Medical Center E-Mail: tmcinfo@texmedctr.tmc.edu URL: http://www.tmc.edu/tmcnews/08_01_01/page_16.html |