Objective: There is limited research on neurocognitive outcome and associated risk factors in long-term, adult survivors of childhood acute lymphoblastic leukemia (ALL), without treatment of cranial radiation therapy. Moreover, the impact of fatigue severity and pain interference on neurocognition has received little attention. In this cross-sectional study, we examined neurocognitive outcome and associated factors in this population. Method: Intellectual abilities, verbal learning/memory, processing speed, attention, and executive functions were compared to normative means/medians with one sample t tests or Wilcoxon signed-rank tests. Associations with risk factors, fatigue severity, and pain interference were analyzed with linear regressions. Results: Long-term, adult survivors of childhood ALL (N = 53, 51% females, mean age = 24.4 years, SD = 4.4, mean = 14.7 years post-diagnosis, SD = 3.4) demonstrated above average intellectual abilities, but performed below average in attention, inhibition, processing speed, and shifting (p < 0.001). Executive functioning complaints were significantly higher than normative means, and positively associated with fatigue (p < 0.001). There was no interaction between sex and fatigue and no neurocognitive impairments were associated with pain interference, risk group, age at diagnosis, or sex. Conclusions: Long-term, adult survivors of ALL treated without cranial radiation therapy, demonstrate domain-specific performance-based neurocognitive impairments. However, continued research on the neurocognitive outcome in this population as they age will be important in the coming years. Executive functioning complaints were frequently in the clinical range, and often accompanied by fatigue. This suggests a need for cognitive rehabilitation programs.

中文翻译：

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未经颅脑放射治疗的儿童急性淋巴细胞白血病长期成年幸存者的神经认知结果和相关因素

目的：对于未经颅脑放射治疗的儿童急性淋巴细胞白血病（ALL）长期成年幸存者的神经认知结果和相关危险因素的研究有限。此外，疲劳严重程度和疼痛干扰对神经认知的影响很少受到关注。在这项横断面研究中，我们检查了该人群的神经认知结果和相关因素。方法：将智力、言语学习/记忆、处理速度、注意力和执行功能与一个样本的标准平均值/中位数进行比较t检验或 Wilcoxon 符号秩检验。通过线性回归分析与危险因素、疲劳严重程度和疼痛干扰的关联。结果：儿童 ALL 的长期成年幸存者（氮= 53，51% 为女性，平均年龄 = 24.4 岁，标清= 4.4，平均 = 诊断后 14.7 年，标清= 3.4）表现出高于平均水平的智力能力，但在注意力、抑制力、处理速度和转移方面表现低于平均水平（p< 0.001）。执行功能投诉显着高于正常平均值，并且与疲劳呈正相关（p< 0.001）。性和疲劳之间没有相互作用，并且神经认知障碍与疼痛干扰、风险群体、诊断时年龄或性别无关。结论：长期未接受颅脑放射治疗的 ALL 成年幸存者表现出基于特定领域表现的神经认知障碍。然而，在未来几年中，继续研究该人群随着年龄增长的神经认知结果将非常重要。执行功能主诉经常出现在临床范围内，并且常常伴有疲劳。这表明需要认知康复计划。