Educational attainment in long-term survivors of childhood acute lymphoblastic leukemia

Some people who survive childhood acute lymphoblastic leukemia (ALL) may face educational difficulties, but most seem to overcome these challenges by adulthood. Treatment for ALL may include cranial radiotherapy (CRT) which may affect IQ or scholastic achievement. Researchers interviewed 1,002 adults, 593 of whom had survived childhood ALL, to evaluate the effect of cancer treatment on educational attainment. ALL survivors were three times more likely than the others to have participated in childhood special education programs (SEP) or learning disabled programs (LDP). High doses of CRT were the strongest predictor of entrance into an LDP program. Overall, ALL patients had comparable or lower high school grades than the other adults. The rates of high school graduation, enrollment in college, and college graduation were similar among most groups of ALL survivors and the other adults. ALL adults who had been treated with 24 Gy of CRT and those who were diagnosed when they were under six years old were less likely to go to college.
Objective.--To determine the impact of treatment on scholastic performance in the first cohort of survivors of childhood acute lymphoblastic leukemia who are old enough to have completed their educational experience. Design.--Retrospective cohort study. Setting.--Twenty-three institutions in the Childrens Cancer Group. Subjects.--A total of 593 adult survivors of childhood acute lymphoblastic leukemia and 409 sibling controls. Outcome Measures.--Enrollment in special programs, grades during high school, graduation from high school, college admission, and college graduation. Results.--After diagnosis, survivors were more likely than their sibling controls to enter a special education (relative risk [RR] =3.4; P Conclusions.--This large study demonstrates that childhood acute lymphoblastic leukemia survivors have a greater likelihood of being placed in special education or learning disabled programs than their siblings, but that most are able to overcome these problems. Dose of cranial radiotherapy and age at diagnosis are the most important education-related risk factors.