Articles

Emotional/Behavioral Problems in Children with Acute Lymphoblastic Leukemia: A Case-Control Study

Abstract

Introduction: Despite achievements in treating acute lymphoblastic leukemia (ALL) in children, its burden on the psychosocial status of patients is not well defined yet. This study aims to determine the impact of childhood ALL on emotional and behavioral pattern of the patients compared to healthy peers as assessed by the Child Behavior Checklist (CBCL).
Methods:
We studied 100 children with ALL (aged 6-12 years) and 100 healthy sex/age peers as control group. All ALL cases were treated by chemotherapy alone. After being informed by a psychologist, parents in both groups were asked to complete the CBCL form. Final results were then compared between the two study groups.
Results:
There were no significant differences between the groups regarding the general characteristics. Failure in school performance, restricted group activity and less social relations were significantly higher in the ALL cases. Total competence was also significantly disturbed for the ALL cases. Social problems, attention problems, aggressive behavior, externalization, attention deficit/hyperactivity, conduct and oppositional defiant problems were significantly more prevalent in healthy children. Somatic problems were significantly higher in the ALL cases.
Conclusion:
Our findings suggest that except for somatic problems, behavioral problems among the ALL cases are significantly less frequent than the healthy peers, which may stem from better care and support from the families. Our unique findings emphasize the need for more research on the psychosocial status of children with cancer in future.

Basta NO, James PW, Gomez-Pozo B, Craft AW, McNally RJ. Survival from childhood cancer in northern England, 1968-2005. Br J Cancer. 2011; 105:1402-8.

Savage E, Riordan AO, Hughes M. Quality of life in children with acute lymphoblastic leukaemia: a systematic review. Eur J Oncol Nurs. 2009;13:36-48.

Ribera JM, Oriol A, Sanz MA, Tormo M, Fernandez-Abellan P, del Potro E, et al. Comparison of the results of the treatment of adolescents and young adults with standard-risk acute lymphoblastic leukemia with the Programa Espanol de Tratamiento en Hematologia pediatric-based protocol ALL-96. Journal of Clinical Oncology. 2008; 26:1843-9.

Pui CH. Toward a total cure for acute lymphoblastic leukemia. Journal of Clinical Oncology. 2009; 27:5121-3.

Lucia A, Ramirez M, San Juan AF, Fleck SJ, Garcia-Castro J, Madero L. Intrahospital supervised exercise training: a complementary tool in the therapeutic armamentarium against childhood leukemia. Leukemia. 2005; 19:1334-7.

San Juan AF, Chamorro-Vina C, Mate-Munoz JL, Fernandez del Valle M, Cardona C, Hernandez M, et al. Functional capacity of children with leukemia. Int J Sports Med. 2008;29:163-7.

Caprino D, Wiley TJ, Massimo L. Childhood cancer survivors in the dark. Journal of Clinical Oncology. 2004; 22:2748-50.

Leung W, Hudson MM, Strickland DK, Phipps S, Srivastava DK, Ribeiro RC, et al. Late effects of treatment in survivors of childhood acute myeloid leukemia. Journal of Clinical Oncology. 2000; 18:3273-9.

Schultz KA, Ness KK, Whitton J, Recklitis C, Zebrack B, Robison LL, et al. Behavioral and social outcomes in adolescent survivors of childhood cancer: a report from the childhood cancer survivor study. Journal of Clinical Oncology. 2007; 25:3649-56.

von der Weid NX. Adult life after surviving lymphoma in childhood. Support Care Cancer. 2008; 16:339-45.

Dejong M, Fombonne E. Depression in paediatric cancer: an overview. Psychooncology. 2006; 15:553-66.

Shahrivar Z, Shirazi E, Yazdi AB, Alghband-rad J. Validity of the Child Behavior Checklist-Persian Version in a Community Sample of Iranian Youths. Iranian Journal of Psychiatry and Behavioral Sciences. 2011; 5:45-9.

Achenbach TM. Manual for the child behavior checklist/4-18 and 1991 profile. Burlington, VT: Dept. of Psychiatry, University of Vermont; 1991.

Achenbach TM, Rescorla L. Manual for the ASEBA preschool forms & profiles : an integrated system of multi-informant assessment. Burlington, Vt.: ASEBA; 2000.

Langeveld NE, Stam H, Grootenhuis MA, Last BF. Quality of life in young adult survivors of childhood cancer. Support Care Cancer. 2002; 10:579-600.

Zebrack BJ, Zeltzer LK, Whitton J, Mertens AC, Odom L, Berkow R, et al. Psychological outcomes in long-term survivors of childhood leukemia, Hodgkin's disease, and non-Hodgkin's lymphoma: a report from the Childhood Cancer Survivor Study. Pediatrics. 2002; 110:42-52.

Campbell LK, Scaduto M, Van Slyke D, Niarhos F, Whitlock JA, Compas BE. Executive function, coping, and behavior in survivors of childhood acute lymphocytic leukemia. J Pediatr Psychol. 2009; 34:317-27.

Noll RB, MacLean WE, Jr., Whitt JK, Kaleita TA, Stehbens JA, Waskerwitz MJ, et al. Behavioral adjustment and social functioning of long-term survivors of childhood leukemia: parent and teacher reports. J Pediatr Psychol. 1997; 22:827-41.

Michalowski M, Ketzer C, Daudt L, Rohde LA. Emotional and behavioral symptoms in children with acute leukemia. Haematologica. 2001; 86:821-6.

Sawyer M, Crettenden A, Toogood I. Psychological adjustment of families of children and adolescents treated for leukemia. Am J Pediatr Hematol Oncol. 1986; 8:200-7.

Barrera M, Atenafu E, Pinto J. Behavioral, social, and educational outcomes after pediatric stem cell transplantation and related factors. Cancer. 2009; 115:880-9.

Liang HF, Chiang YC, Chien LY, Yeh CH. A comparison of emotional/behavioural problems between Taiwanese children with cancer and healthy controls. J Clin Nurs. 2008; 17:304-11.

Dolson EP, Conklin HM, Li C, Xiong X, Merchant TE. Predicting behavioral problems in craniopharyngioma survivors after conformal radiation therapy. Pediatr Blood Cancer. 2009; 52:860-4.

Wolfe-Christensen C, Mullins LL, Scott JG, McNall-Knapp RY. Persistent psychosocial problems in children who develop posterior fossa syndrome after medulloblastoma resection. Pediatr Blood Cancer. 2007; 49:723-6.

Buizer AI, de Sonneville LM, van den Heuvel-Eibrink MM, Veerman AJ. Behavioral and educational limitations after chemotherapy for childhood acute lymphoblastic leukemia or Wilms tumor. Cancer. 2006; 106:2067-75.

Lofstad GE, Reinfjell T, Hestad K, Diseth TH. Cognitive outcome in children and adolescents treated for acute lymphoblastic leukaemia with chemotherapy only. Acta Paediatr. 2009;98:180-6.

Rey-Casserly C, Meadows ME. Developmental perspectives on optimizing educational and vocational outcomes in child and adult survivors of cancer. Dev Disabil Res Rev. 2008; 14:243-50.

Utens EM, Verhulst FC, Duivenvoorden HJ, Meijboom FJ, Erdman RA, Hess J. Prediction of behavioural and emotional problems in children and adolescents with operated congenital heart disease. Eur Heart J. 1998; 19:801-7.

Mulhern RK, Butler RW. Neurocognitive sequelae of childhood cancers and their treatment. Pediatr Rehabil. 2004; 7:1-14; discussion 5-6.

Conklin HM, Reddick WE, Ashford J, Ogg S, Howard SC, Morris EB, et al. Long-term efficacy of methylphenidate in enhancing attention regulation, social skills, and academic abilities of childhood cancer survivors. J Clin Oncol. 2010; 28:4465-72.

Kahalley LS, Wilson SJ, Tyc VL, Conklin HM, Hudson MM, Wu S, et al. Are the psychological needs of adolescent survivors of pediatric cancer adequately identified and treated? Psychooncology. 2013; 22:447-58.

Files
IssueVol 8, No 2 (2014) QRcode
SectionArticles
Keywords
Acute Lymphoblastic Leukemia Behavioral Problem Child Behavior Checklist Childhood Cancer

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Nazari S, Koupaei MTS, Shafiee A, Kashani ZHG, Bahraminia E, Ansari M, Alipour A. Emotional/Behavioral Problems in Children with Acute Lymphoblastic Leukemia: A Case-Control Study. Int J Hematol Oncol Stem Cell Res. 1;8(2):14-20.