Behavioral Symptoms and Psychiatric Disorders in Child and Adolescent Long-Term Survivors of Childhood Acute Lymphoblastic Leukemia Treated with Chemotherapy Only

Long-term survivors of childhood ALL treated with chemotherapy only had significantly higher rates of self-reported inattention (27.9%) and parent-reported attention problems (23.6%) compared to the 1

Effect: decline; 27.9% impaired (self-report inattention) and 23.6% impaired (parent-report attention problems) vs 10% expected; CI: 95% CI 21.0-35.7% (self-r

Long-term survivors of childhood ALL had significantly elevated rates of self-reported oppositional defiant symptoms (20.1%) and parent-reported ODD diagnosis (16.0%) compared to population norms, wit

Effect: decline; 20.1% self-reported ODD symptoms vs 10% expected; 16.0% ODD diagnosis vs 9.5% expected; CI: 95% CI 14.1-27.3% (self-report symptoms); 95% CI

Long-term survivors of childhood ALL had a five-fold higher rate of Obsessive-Compulsive Disorder (10.3%) compared to the general population (2%), and this diagnosis was more strongly associated with

Effect: decline; 10.3% vs 2% expected; CI: 95% CI 6.0-16.2%

Long-term survivors of childhood ALL had significantly LOWER rates of Conduct Disorder (0.6% vs 10.9%) and Major Depressive Disorder (1.3% vs 15.4%) compared to the general population, suggesting prot

Effect: improvement; Conduct Disorder: 0.6% vs 10.9% expected; MDD: 1.3% vs 15.4% expected; CI: 95% CI 0.0-3.5% (Conduct Disorder); 95% CI 0.2-4.6% (MDD)

Chemotherapy treatment intensity (HDMTX exposure, intrathecal therapy doses, and cumulative dexamethasone dose) was not associated with any child self-reported or parent-reported behavioral symptoms o

Effect: null; RR 0.98 (95% CI 0.96-1.01) for HDMTX AUC on inattention; all p-values > 0.05 after FDR correction across all treatment-outcome combinations

Parent emotional distress and PTSS were significantly associated with parent-reported child anxiety disorders (GAD, OCD) and atypicality, but NOT with the survivor's own self-reported anxiety symptoms

Effect: decline; Parent self-reported anxiety, depression and PTSS showed significantly higher risk for parent report of survivor anxiety, atypicality, Genera