Journal Article Annotations
2016, 2nd Quarter
Annotations by Audrey Walker, MD, FAPM
The finding: This longitudinal study of adolescent survivors of childhood-onset cancers identified subgroups of patients who had clinically significant behavioral, social and emotional comorbidities.
Strengths and weaknesses: This study is the first of its kind, and followed a large cohort of survivors of childhood-onset cancers into adolescence. The patient group included a variety of cancer diagnoses, an element of heterogeneity that could potentially weaken the results.
Relevance: This large, longitudinal study is the first to identify adolescent patient groups at risk of mental health comorbidities following treatment of childhood-onset cancers. This knowledge will improve screening guidelines and allow for early intervention in these at-risk teenagers, with the hope of preventing adverse behavioral health outcomes in this at-risk group of young people.
The finding: In this longitudinal study of long-term survivors of pediatric acute lymphoblastic leukemia (ALL), higher exposure to methotrexate was associated with executive dysfunction as well as lower scores on verbal fluency, spatial memory and numerical processing speed.
Strengths and weaknesses: This study used pharmacokinetic exposure and biomarker parameters to predict outcomes. This permitted a more precise understanding of inter-patient variability in chemotherapeutic drug metabolism and its association with long-term neurocognitive outcomes.
Relevance: The 5-year survival rate for pediatric ALL is currently 95%. A better understanding of the long-term neurotoxicity of chemotherapy and a reduction of these effects will have a powerful impact on the long-term quality of life in this group of young patients.