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Neurocognitive Late Effects of Chemotherapy

For many children with cancer, chemotherapy can be a true lifesaver, or, can at least prolong a child's life. However, chemotherapy does not come without costs. One of these is late effects--adverse side effects of chemotherapy that arise after treatment, or do not go away following treatment. Some of these late, adverse side effects affect the neurocognitive system.

  1. Types of Cancer in Which Neurocognitive Late Effects are Commonly Seen

    • Neurocognitive late effects of chemotherapy are seen more often in two types of childhood cancer: Acute Lymphoblastic Leukemia (or ALL) and childhood brain tumors, such as medulloblastoma.

    Why Neurocognitive Late Effects are Seen in These Cancers

    • Higher doses of radiation are used in chemotherapy to treat these two types of cancers, possibly accounting for the higher incidence of neurocognitive late effects found in these cancers.

    Leukoencephalopathy

    • One of the neurocognitive late effects found in Acute Lymphoblastic Leukemia (ALL) is leukoencephalopathy, or abnormal white matter in the brain. Symptoms of this include lethargy, seizures, slurred speech, ataxia and loss of memory.

    Mineralizing Microangiopathy

    • Mineralizing microangiopathy is another neurocognitive late side effect seen after treatment of ALL. It involves calcification within basal ganglia and white matter, evident on MRI and CT scans. Symptoms include problems with motor skills, memory, attention and concentration.

    Deficiencies Seen in Survivors of Brain Tumors

    • Many children treated for brain tumors such as medulloblastoma emerge with problems with verbal IQ, problems with spatial memory and motor skills deficits. Depending upon the site of the tumor, deficits vary.

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