Leukemia therapy can impair school performance

NEW YORK, Aug 31 (Reuters) Certain treatments may affect the scholastic achievement of childhood leukemia survivors, Finnish researchers report in the Journal of Clinical Oncology.

However, many of these treated children do not appear to be disadvantaged.

Radiation therapy to the brain was the treatment most harmful to school performance in children with leukemia in this study, lead investigator Dr Arja Harila-Saari told Reuters Health. ''The results support the ongoing efforts to omit cranial radiation therapy completely from the first-line treatment of childhood leukemia.'' Harila-Saari of Oulu University Hospital and colleagues studied 371 patients born between 1974 and 1986, who had a leukemia diagnosis before the age of 16 years. The characteristics of each former leukemia patient were matched to five ''controls,'' a comparison group without a cancer history.

Comparisons were made based on ninth grade school reports for overall average grades and grades for language, foreign language, mathematics and physical education.

In patients who were treated with chemotherapy alone, only girls who were diagnosed with the disease before the age of 7 years had lower marks than the controls, and the difference, said Harila-Saari, was ''reasonably modest.'' Children who underwent cranial radiation had lower marks than controls. Girls who underwent this procedure when particularly young showed the greatest difference from controls in scores on foreign language.

Overall, the results are a relief ''regarding the cognitive side effects of chemotherapy alone in children with leukemia,'' continued Dr. Harila-Saari.

''Nearly all the children with leukemia completed basic education,'' she added ''and achieved a solid foundation for further schooling. Education was provided for all children with leukemia when they were hospitalised or at home, but not able to go to school. Remedial teaching and support for school work were readily available.'' The results, Harila-Saari concluded, ''encourage the arrangement of these types of services for all children with leukemia.'' REUTERS GT BST0857