Biomarkers and Cognitive Function in Children and Adolescents During Maintenance Therapy for Leukemia

Mary C. Hooke

Michelle A. Mathiason

Alicia S. Kunin-Batson

Audrey Blommer

Jessica Hutter

Pauline A. Mitby

Ida M. Moore

Susan Whitman

Olga Taylor

Michael E. Scheurer

Marilyn J. Hockenberry

acute lymphoblastic leukemia, cognitive function, biomarkers, childhood cancer
ONF 2021, 48(6), 623-633. DOI: 10.1188/21.ONF.623-633

Objectives: To explore the relationship between biomarkers of oxidative stress and inflmmation in cerebrospinal fluid (CSF) and cognitive function in children receiving maintenance therapy for acute lymphocytic leukemia (ALL).

Sample & Setting: 30 participants aged 4–17 years receiving ALL maintenance therapy at two pediatric cancer centers in the United States.

Methods & Variables: F2-isoprostane (F2-ISoP) and interleukin-8 (IL-8) were evaluated in CSF samples, and cognitive function measures were completed during the first and last cycles of ALL maintenance. The Flanker Inhibitory Control and Attention Test (Flanker) and Dimensional Change Card Sort were completed during the last cycle.

Results: During maintenance therapy, IL-8 decreased, and parent reports of children’s cognitive function improved. Higher IL-8 was associated with better parent reports of children’s cognitive function at each timepoint. Higher F2-ISoP levels were associated with lower Flanker scores.

Implications for Nursing: F2-ISoP may be a useful biomarker in evaluating cognitive dysfunction in children with ALL and merits further investigation.

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