Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Pediatric Transplants

Cognitive, educational, psychosocial adjustment and quality of life of children who survive hematopoietic SCT and their siblings

Abstract

Our objective was to compare cognitive, educational and psychosocial outcomes, and quality of life (QOL) of pediatric hematopoietic SCT (HSCT) survivors with those of their siblings, 2 years post-HSCT. Forty-six HSCT survivors, with age ranging from 3 to 16 years, and 33 siblings, with age ranging from 3 to 20 years, participated. Standardized tests were performed and questionnaires were completed by the participating children and their mothers. Survivors’ full, verbal and performance IQ scores did not differ significantly from those of their siblings. Survivors, however, had significantly higher perceptual organization scores than their siblings. Siblings’ mean scores on spelling were significantly higher than those of survivors, but arithmetic and reading scores were not. Siblings had significantly more internalizing problems than survivors. Siblings’ physical QOL scores were significantly better than those of survivors. Finally, child age, maternal depression scores and age, and family cohesion were related to cognitive and educational differences. A history of cranial radiation and a diagnosis of neuroblastoma or Hodgkin's lymphoma in survivors were related to the difference in internalizing scores. Except for some deficits in educational outcomes and physical QOL, survivors’ cognitive and psychological outcomes at 2 years post-HSCT were similar to those of their siblings. Family and clinical factors were identified as critical for these outcomes.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. McGuire T, Sanders JE, Hill D, Buckner CD, Sullivan K . Neuropsychological function in children given total-body irradiation for marrow transplantation. Exp Hematol 1991; 19: 578.

    Google Scholar 

  2. Smedler AC, Nilsson C, Bolme P . Total body irradiation: a neuropsychological risk factor in pediatric bone marrow transplant recipients. Acta Paediatr 1995; 84: 325–330.

    Article  CAS  PubMed  Google Scholar 

  3. Barrera M, Atenafu E, Andrews GS, Saunders F . Factors related to changes in cognitive, academic and visual motor integration in children who undergo hematopoietic stem cell transplant. J Pediatr Psychol; advance online access, October 25, 2007; doi:10.1093/JPPSY/JSM080.

  4. Phipps S, Dunavant M, Srivastava DK, Bowman L, Mulhern RK . Cognitive and academic functioning in survivors of pediatric bone marrow transplantation. J Clin Oncol 2000; 18: 1004–1011.

    Article  CAS  PubMed  Google Scholar 

  5. Brown RT, Madan-Swain A, Pais R, Lambert RG, Baldwin K, Casey R et al. Cognitive status of children treated with central nervous system prophylactic chemotherapy for acute lymphocytic leukemia. Arch Clin Neuropsychol 1992; 7: 481–497.

    Article  CAS  PubMed  Google Scholar 

  6. Buizer AI, de Sonneville LMJ, van den Heuvel-Eibrink MM, Veerman AJP . Behavioral and educational limitations after chemotherapy for childhood acute lymphoblastic leukemia or Wilms tumor. Cancer 2006; 106: 2067–2075.

    Article  PubMed  Google Scholar 

  7. Copeland DR, deMoor C, Moore BD, Ater JL . Neurocognitive development of children after a cerebellar tumor in infancy: a longitudinal study. J Clin Psychol 1999; 17: 3476–3486.

    CAS  Google Scholar 

  8. Mennes M, Stiers P, Vandenbussche E, Vercruysse G, Uyttebroeck A, De Meyer G et al. Attention and information processing in survivors of childhood acute lymphoblastic leukemia treated with chemotherapy only. Pediatr Blood Cancer 2005; 44: 478–486.

    Article  PubMed  Google Scholar 

  9. Raymond-Speden E, Tripp G, Lawrence B, Holdaway D . Intellectual, neuropsychological, and academic functioning in long-term survivors of leukemia. J Pediatr Psychol 2000; 25: 59–68.

    Article  CAS  PubMed  Google Scholar 

  10. Alderfer MA, Labay LE, Kazak AE . Brief report: does posttraumatic stress apply to siblings of childhood cancer? J Pediatr Psychol 2003; 28: 281–286.

    Article  PubMed  Google Scholar 

  11. Cairns NU, Clark GM, Smith SD, Lansky SB . Adaptation of siblings to childhood malignancy. J Pediatr 1979; 95: 484–487.

    Article  CAS  PubMed  Google Scholar 

  12. Labay LE, Walco GA . Brief report: empathy and psychological adjustment in siblings of children with cancer. J Pediatr Psychol 2004; 29: 309–314.

    Article  PubMed  Google Scholar 

  13. Murray J . Siblings of children with cancer: a review of the literature. J Pediatr Oncol Nurs 1999; 16: 25–34.

    CAS  PubMed  Google Scholar 

  14. Sawyer MG, Toogood I, Rice M, Haskell C, Baghurst P . School performance and psychological adjustment of children treated for leukemia. A long term follow up. Am J Pediatr Hematol Oncol 1989; 11: 146–152.

    CAS  PubMed  Google Scholar 

  15. 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; 100: 42–52.

    Article  Google Scholar 

  16. Packman WL, Crittenden MR, Schaeffer E, Bongar B, Fischer JB, Cowan MJ . Psychosocial consequences of bone marrow transplantation in donor and non donor siblings. Dev Behav Pediatr 1997; 18: 244–253.

    Article  CAS  Google Scholar 

  17. Barrera M, Wayland LA, D’Agostino N, Gibson J, Weksberg R, Malkin D . Developmental differences in psychological adjustment and health related quality of life in pediatric cancer patients. Child Health Care 2003; 12: 215–232.

    Article  Google Scholar 

  18. Barrera M, D’Agostino N, Gibson J, Weksberg R, Malkin D . Predictors and mediators of psychological adjustment in mothers of children newly diagnosed with cancer. Psychooncology 2004; 13: 1–12.

    Article  Google Scholar 

  19. Hollingshead A . Four Factor Index of Social Status. Yale University Press: New Haven, CT, 1975, 27pp.

    Google Scholar 

  20. Wechsler D . Wechsler Intelligence Scale for Children III. The Psychological Corporation: New York, 1991, 294pp.

    Google Scholar 

  21. Wilkinson GS . WRAT3 Wide Range Achievement Test: Administration Manual.. Wide Range Inc.: Wilmington, DE, 1993, 189pp.

    Google Scholar 

  22. Beery KE . Revised Administration, Scoring, and Teaching Manual for the Developmental Test of Visual-Motor Integration. Modern Curriculum Press: Toronto, ON, 1982, 112pp.

    Google Scholar 

  23. Achenbach TM . Manual for the Child Behaviour Checklist/4-18 and 1991 Profile. University of Vermont Department of Psychiatry: Burlington, VT, 1991, 288pp.

    Google Scholar 

  24. Achenbach TM, Edelbrock C . Manual for the Child Behaviour Checklist and Revised Child Behaviour Profile. University of Vermont, Department of Psychiatry: Burlington, VT, 1983, 210pp.

    Google Scholar 

  25. Landgraf JM, Abetz L, Ware JR . Child Health Questionnaire (CHQ): A User's Manual. The Health Institute, New England Medical Centre: Boston, MA, 1996, 571pp.

    Google Scholar 

  26. Olson DH, Portner J, Lavee Y . FACES III. University of Minnesota: St Paul, MN, 1985, 42pp.

    Google Scholar 

  27. Beck AT . Beck Depression Inventory. Psychological Corporation: San Antonio, TX, 1978, 24pp.

    Google Scholar 

  28. Elliott CH, Ozolins M, Olson RA, Pruitt SD . Behavioral management of children's distress during painful medical procedures. Behav Res Ther 1985; 23: 513–520.

    Article  PubMed  Google Scholar 

  29. Katz R, Katz J, Shaw BF . Beck depression inventory and hopelessness scale. In: Maruish ME (ed.) Psychological Testing: Treatment Planning and Outcome Assessment. Lawrence Erlbaum: New York, NY, 1993, pp 120–133.

    Google Scholar 

  30. Sattler JM . Assessment of Children, 3rd edn. Jerome M Sattler: San Diego, CA, 1988, 995pp.

    Google Scholar 

Download references

Acknowledgements

This research was supported by grants from the Hospital for Sick Children Foundation, New Initiatives; Elizabeth Lue Bone Marrow Foundation and the National Cancer Institute of Canada. The authors declare that no financial interests or relationships exist. We thank K Sumbler and T Smith for their help in collecting data for this research and G Andrews, V Jovcevska, T Teall and K Hancock for their help in preparing the manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M Barrera.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Barrera, M., Atenafu, E. Cognitive, educational, psychosocial adjustment and quality of life of children who survive hematopoietic SCT and their siblings. Bone Marrow Transplant 42, 15–21 (2008). https://doi.org/10.1038/bmt.2008.84

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2008.84

Keywords

This article is cited by

Search

Quick links