CLIN-EPIDEMIOLOGY

ABSTRACT: Although most children treated for acute lymphoblastic leukemia (ALL) survive, the noncognitive neurologic sequelae of ALL treatment are inadequately described, and most reported studies utilize self-administered questionnaires. We undertook a prospective, IRB-approved, cross-sectional study to define neurologic morbidity in ALL survivors who were more than 5 years from diagnosis. An investigator administered the questionnaire and disability scales, and a board-certified neurologist performed a quantitative neurologic examination. The PedMIDAS tool was completed to determine headache-related disability. The International Headache Society criteria were applied to classify headache type. Of 375 long-term survivors available, 162 consented and participated in the study. There were no significant differences in clinical or biological features between participants and non-participants. Headache was reported by 76 (47%) of the 162 patients: 34 of 70 (49%) girls and 42 of the 92 boys (46%). Median time from onset of the first headache episode was 5.7 years (0.1-18 years), and median age at headache onset was 9.5 years (3.1-27 years). Migraine was diagnosed in 46 survivors (61%), and 25 experienced one or more aura. Episodic tension-type headache was present in 39 (51%) patients, and 17 patients (22%) experienced both migraine and tension-type headaches. Chronic daily headaches were present in 12 survivors (8 with migraine and 4 with tension-type headache). Among survivors with headache, 13 (17%) reported a frequent need to interrupt activities, 36 (47%) occasionally restricted activity, and 27 (36%) did not restrict activity during a headache episode. More than two-thirds (67%) had never seen a physician for headache, and only 8% had visited the hospital emergency room over the last year. PedMIDAS scores revealed no headache-related disability in 42 (55%) patients, mild disability in 22 (29%) patients, and moderate disability in 12 (16%) patients. In conclusion, migraine and tension-type headaches are common in ALL survivors, affect both sexes equally, and in general cause relatively little morbidity.

SUBMITTER: Khan R 

PROVIDER: S-EPMC3488775 | biostudies-literature | 2012 Oct

REPOSITORIES: biostudies-literature