Neuropsychological functioning after treatment for hematological malignancies in childhood, including autologous bone marrow transplantation

Neuropsychological functioning and academic achievement were assessed in 26 patients 2-10 years after autologous bone marrow transplantation (ABMT)for childhood hematological malignancies. Serial tests of general intelligence before and after ABMT were supplemented with a cross-sectional study of neuropsychological functioning. Test results for general intelligence were in the normal range and mainly unaffected over time, but below average performance in specific neuropsychological tests was found in a higher number of children than expected especially for the variables "Strategies, " "Attention, " and "Memory. " All school children were in regular classes; 5/15 obtained extra tutorial help and two of them had major learning difficulties. Eight young adults reported normal academic achievement. Low age at diagnosis and long time since ABMT correlated significantly with lower test results on general intelligence and "Attention," and high intensity of treatment directed to the central nervous system correlated with more canting difficulties as assessed by teachers. Children with identified problems in school were offered educational counseling based on their test profiles. To enable such counseling, it is suggested that both IQ tests and neuropsychological tests on memory and attention be included in follow-up programs for children who have received high-intensity cancer treatment.