Neuropsychological outcomes of patients with low-grade glioma diagnosed during the first year of life

Andrew M. Heitzer, Jason M. Ashford, Camden Hastings, Anthony P.Y. Liu, Shengjie Wu, Johnnie K. Bass, Robert Vestal, Mary Hoehn, Jason Chiang, Yahya Ghazwani, Sahaja Acharya, Frederick Boop, Amar Gajjar, Thomas E. Merchant, Ibrahim Qaddoumi, Heather M. Conklin

Research output: Contribution to journalArticle

Abstract

Purpose: Low-grade gliomas (LGG) are a heterogeneous group of brain tumors, which are often assumed to have a benign course. Yet, children diagnosed and treated for LGG in infancy are at increased risk for neurodevelopmental disruption. We sought to investigate neuropsychological outcomes of infants diagnosed with LGG. Methods: Between 1986 and 2013, 51 patients were diagnosed with LGG before 12 months of age and managed at St. Jude Children’s Research Hospital. Twenty-five of the 51 patients received a cognitive assessment (68% male; 6.8 ± 3.3 months at diagnosis; 10.5 ± 4.8 years at latest assessment). Approximately half the patients received radiation therapy (n = 12; aged 4.0 ± 3.0 years at radiation therapy), with a median of 2 chemotherapy regimens (range = 0–5) and 1 tumor directed surgery (range = 0–5). Results: The analyses revealed performance below age expectations on measures of IQ, memory, reading, mathematics, and fine motor functioning as well as parent-report of attention, executive, and adaptive functioning. Following correction for multiple comparisons, a greater number of chemotherapy regimens was associated with lower scores on measures of IQ and mathematics. More tumor directed surgeries and presence of visual field loss were associated with poorer dominant hand fine motor control. Radiation therapy exposure was not associated with decline in neuropsychological performance. Conclusions: Children diagnosed with LGG in infancy experience substantial neuropsychological deficits. Treatment factors, including number of chemotherapy regimens and tumor directed surgeries, may increase risk for neurodevelopmental disruption and need to be considered in treatment planning.

Original languageEnglish (US)
Pages (from-to)413-420
Number of pages8
JournalJournal of Neuro-Oncology
Volume141
Issue number2
DOIs
StatePublished - Jan 30 2019

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Glioma
Radiotherapy
Mathematics
Drug Therapy
Neoplasms
Visual Fields
Brain Neoplasms
Reading
Hand
Therapeutics
Research

All Science Journal Classification (ASJC) codes

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research

Cite this

Heitzer, A. M., Ashford, J. M., Hastings, C., Liu, A. P. Y., Wu, S., Bass, J. K., ... Conklin, H. M. (2019). Neuropsychological outcomes of patients with low-grade glioma diagnosed during the first year of life. Journal of Neuro-Oncology, 141(2), 413-420. https://doi.org/10.1007/s11060-018-03048-0

Neuropsychological outcomes of patients with low-grade glioma diagnosed during the first year of life. / Heitzer, Andrew M.; Ashford, Jason M.; Hastings, Camden; Liu, Anthony P.Y.; Wu, Shengjie; Bass, Johnnie K.; Vestal, Robert; Hoehn, Mary; Chiang, Jason; Ghazwani, Yahya; Acharya, Sahaja; Boop, Frederick; Gajjar, Amar; Merchant, Thomas E.; Qaddoumi, Ibrahim; Conklin, Heather M.

In: Journal of Neuro-Oncology, Vol. 141, No. 2, 30.01.2019, p. 413-420.

Research output: Contribution to journalArticle

Heitzer, AM, Ashford, JM, Hastings, C, Liu, APY, Wu, S, Bass, JK, Vestal, R, Hoehn, M, Chiang, J, Ghazwani, Y, Acharya, S, Boop, F, Gajjar, A, Merchant, TE, Qaddoumi, I & Conklin, HM 2019, 'Neuropsychological outcomes of patients with low-grade glioma diagnosed during the first year of life', Journal of Neuro-Oncology, vol. 141, no. 2, pp. 413-420. https://doi.org/10.1007/s11060-018-03048-0
Heitzer, Andrew M. ; Ashford, Jason M. ; Hastings, Camden ; Liu, Anthony P.Y. ; Wu, Shengjie ; Bass, Johnnie K. ; Vestal, Robert ; Hoehn, Mary ; Chiang, Jason ; Ghazwani, Yahya ; Acharya, Sahaja ; Boop, Frederick ; Gajjar, Amar ; Merchant, Thomas E. ; Qaddoumi, Ibrahim ; Conklin, Heather M. / Neuropsychological outcomes of patients with low-grade glioma diagnosed during the first year of life. In: Journal of Neuro-Oncology. 2019 ; Vol. 141, No. 2. pp. 413-420.
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abstract = "Purpose: Low-grade gliomas (LGG) are a heterogeneous group of brain tumors, which are often assumed to have a benign course. Yet, children diagnosed and treated for LGG in infancy are at increased risk for neurodevelopmental disruption. We sought to investigate neuropsychological outcomes of infants diagnosed with LGG. Methods: Between 1986 and 2013, 51 patients were diagnosed with LGG before 12 months of age and managed at St. Jude Children’s Research Hospital. Twenty-five of the 51 patients received a cognitive assessment (68{\%} male; 6.8 ± 3.3 months at diagnosis; 10.5 ± 4.8 years at latest assessment). Approximately half the patients received radiation therapy (n = 12; aged 4.0 ± 3.0 years at radiation therapy), with a median of 2 chemotherapy regimens (range = 0–5) and 1 tumor directed surgery (range = 0–5). Results: The analyses revealed performance below age expectations on measures of IQ, memory, reading, mathematics, and fine motor functioning as well as parent-report of attention, executive, and adaptive functioning. Following correction for multiple comparisons, a greater number of chemotherapy regimens was associated with lower scores on measures of IQ and mathematics. More tumor directed surgeries and presence of visual field loss were associated with poorer dominant hand fine motor control. Radiation therapy exposure was not associated with decline in neuropsychological performance. Conclusions: Children diagnosed with LGG in infancy experience substantial neuropsychological deficits. Treatment factors, including number of chemotherapy regimens and tumor directed surgeries, may increase risk for neurodevelopmental disruption and need to be considered in treatment planning.",
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AU - Heitzer, Andrew M.

AU - Ashford, Jason M.

AU - Hastings, Camden

AU - Liu, Anthony P.Y.

AU - Wu, Shengjie

AU - Bass, Johnnie K.

AU - Vestal, Robert

AU - Hoehn, Mary

AU - Chiang, Jason

AU - Ghazwani, Yahya

AU - Acharya, Sahaja

AU - Boop, Frederick

AU - Gajjar, Amar

AU - Merchant, Thomas E.

AU - Qaddoumi, Ibrahim

AU - Conklin, Heather M.

PY - 2019/1/30

Y1 - 2019/1/30

N2 - Purpose: Low-grade gliomas (LGG) are a heterogeneous group of brain tumors, which are often assumed to have a benign course. Yet, children diagnosed and treated for LGG in infancy are at increased risk for neurodevelopmental disruption. We sought to investigate neuropsychological outcomes of infants diagnosed with LGG. Methods: Between 1986 and 2013, 51 patients were diagnosed with LGG before 12 months of age and managed at St. Jude Children’s Research Hospital. Twenty-five of the 51 patients received a cognitive assessment (68% male; 6.8 ± 3.3 months at diagnosis; 10.5 ± 4.8 years at latest assessment). Approximately half the patients received radiation therapy (n = 12; aged 4.0 ± 3.0 years at radiation therapy), with a median of 2 chemotherapy regimens (range = 0–5) and 1 tumor directed surgery (range = 0–5). Results: The analyses revealed performance below age expectations on measures of IQ, memory, reading, mathematics, and fine motor functioning as well as parent-report of attention, executive, and adaptive functioning. Following correction for multiple comparisons, a greater number of chemotherapy regimens was associated with lower scores on measures of IQ and mathematics. More tumor directed surgeries and presence of visual field loss were associated with poorer dominant hand fine motor control. Radiation therapy exposure was not associated with decline in neuropsychological performance. Conclusions: Children diagnosed with LGG in infancy experience substantial neuropsychological deficits. Treatment factors, including number of chemotherapy regimens and tumor directed surgeries, may increase risk for neurodevelopmental disruption and need to be considered in treatment planning.

AB - Purpose: Low-grade gliomas (LGG) are a heterogeneous group of brain tumors, which are often assumed to have a benign course. Yet, children diagnosed and treated for LGG in infancy are at increased risk for neurodevelopmental disruption. We sought to investigate neuropsychological outcomes of infants diagnosed with LGG. Methods: Between 1986 and 2013, 51 patients were diagnosed with LGG before 12 months of age and managed at St. Jude Children’s Research Hospital. Twenty-five of the 51 patients received a cognitive assessment (68% male; 6.8 ± 3.3 months at diagnosis; 10.5 ± 4.8 years at latest assessment). Approximately half the patients received radiation therapy (n = 12; aged 4.0 ± 3.0 years at radiation therapy), with a median of 2 chemotherapy regimens (range = 0–5) and 1 tumor directed surgery (range = 0–5). Results: The analyses revealed performance below age expectations on measures of IQ, memory, reading, mathematics, and fine motor functioning as well as parent-report of attention, executive, and adaptive functioning. Following correction for multiple comparisons, a greater number of chemotherapy regimens was associated with lower scores on measures of IQ and mathematics. More tumor directed surgeries and presence of visual field loss were associated with poorer dominant hand fine motor control. Radiation therapy exposure was not associated with decline in neuropsychological performance. Conclusions: Children diagnosed with LGG in infancy experience substantial neuropsychological deficits. Treatment factors, including number of chemotherapy regimens and tumor directed surgeries, may increase risk for neurodevelopmental disruption and need to be considered in treatment planning.

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