Pathways linking treatment intensity and psychosocial outcomes among adult survivors of childhood leukemia

Edith Chen; Lonnie K. Zeltzer; Peter M. Bentler; Julianne Byrne; H. Stacy Nicholson; Anna T. Meadows; James L. Mills; Riccardo Haupt; Thomas R. Fears; Leslie L. Robison

doi:10.1177/135910539800300102

Pathways linking treatment intensity and psychosocial outcomes among adult survivors of childhood leukemia

Edith Chen, Lonnie K. Zeltzer, Peter M. Bentler, Julianne Byrne, H. Stacy Nicholson, Anna T. Meadows, James L. Mills, Riccardo Haupt, Thomas R. Fears, Leslie L. Robison

Research output: Contribution to journal › Article › peer-review

22 Scopus citations

Abstract

To determine the pathways between treatment intensity (age at diagnosis, dosage of chemotherapy [intrathecal methotrexate; IT-MTX] and cranial radiation [CRT]) and various psychosocial outcomes, review of medical records and structured interviews were carried out in 510 adult survivors of childhood leukemia. Structural equation modeling revealed that higher treatment intensity during childhood (indicated by treatment with high-dose CRT, low-dose IT-MTX, and adjusted by younger age at diagnosis) predicted more health-compromising behaviors as adults through lower educational achievement. Additionally, higher childhood treatment intensity predicted current negative mood both directly and via changes in perceived limitations. The present study's findings suggest that higher treatment intensity during childhood may serve as a risk factor for adult survivors' health-compromising behaviors through neuropsychological deficits that arise from cancer treatment.

Original language	English (US)
Pages (from-to)	23-38
Number of pages	16
Journal	Journal of Health Psychology
Volume	3
Issue number	1
DOIs	https://doi.org/10.1177/135910539800300102
State	Published - 1998
Externally published	Yes

Keywords

Childhood leukemia
Education
Health behavior
Long-term survivors
Mood
Treatment effects

ASJC Scopus subject areas

Applied Psychology

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10.1177/135910539800300102

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title = "Pathways linking treatment intensity and psychosocial outcomes among adult survivors of childhood leukemia",

abstract = "To determine the pathways between treatment intensity (age at diagnosis, dosage of chemotherapy [intrathecal methotrexate; IT-MTX] and cranial radiation [CRT]) and various psychosocial outcomes, review of medical records and structured interviews were carried out in 510 adult survivors of childhood leukemia. Structural equation modeling revealed that higher treatment intensity during childhood (indicated by treatment with high-dose CRT, low-dose IT-MTX, and adjusted by younger age at diagnosis) predicted more health-compromising behaviors as adults through lower educational achievement. Additionally, higher childhood treatment intensity predicted current negative mood both directly and via changes in perceived limitations. The present study's findings suggest that higher treatment intensity during childhood may serve as a risk factor for adult survivors' health-compromising behaviors through neuropsychological deficits that arise from cancer treatment.",

keywords = "Childhood leukemia, Education, Health behavior, Long-term survivors, Mood, Treatment effects",

author = "Edith Chen and Zeltzer, {Lonnie K.} and Bentler, {Peter M.} and Julianne Byrne and Nicholson, {H. Stacy} and Meadows, {Anna T.} and Mills, {James L.} and Riccardo Haupt and Fears, {Thomas R.} and Robison, {Leslie L.}",

year = "1998",

doi = "10.1177/135910539800300102",

language = "English (US)",

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AU - Chen, Edith

AU - Zeltzer, Lonnie K.

AU - Bentler, Peter M.

AU - Byrne, Julianne

AU - Nicholson, H. Stacy

AU - Meadows, Anna T.

AU - Mills, James L.

AU - Haupt, Riccardo

AU - Fears, Thomas R.

AU - Robison, Leslie L.

PY - 1998

Y1 - 1998

N2 - To determine the pathways between treatment intensity (age at diagnosis, dosage of chemotherapy [intrathecal methotrexate; IT-MTX] and cranial radiation [CRT]) and various psychosocial outcomes, review of medical records and structured interviews were carried out in 510 adult survivors of childhood leukemia. Structural equation modeling revealed that higher treatment intensity during childhood (indicated by treatment with high-dose CRT, low-dose IT-MTX, and adjusted by younger age at diagnosis) predicted more health-compromising behaviors as adults through lower educational achievement. Additionally, higher childhood treatment intensity predicted current negative mood both directly and via changes in perceived limitations. The present study's findings suggest that higher treatment intensity during childhood may serve as a risk factor for adult survivors' health-compromising behaviors through neuropsychological deficits that arise from cancer treatment.

AB - To determine the pathways between treatment intensity (age at diagnosis, dosage of chemotherapy [intrathecal methotrexate; IT-MTX] and cranial radiation [CRT]) and various psychosocial outcomes, review of medical records and structured interviews were carried out in 510 adult survivors of childhood leukemia. Structural equation modeling revealed that higher treatment intensity during childhood (indicated by treatment with high-dose CRT, low-dose IT-MTX, and adjusted by younger age at diagnosis) predicted more health-compromising behaviors as adults through lower educational achievement. Additionally, higher childhood treatment intensity predicted current negative mood both directly and via changes in perceived limitations. The present study's findings suggest that higher treatment intensity during childhood may serve as a risk factor for adult survivors' health-compromising behaviors through neuropsychological deficits that arise from cancer treatment.

KW - Childhood leukemia

KW - Education

KW - Health behavior

KW - Long-term survivors

KW - Mood

KW - Treatment effects

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Pathways linking treatment intensity and psychosocial outcomes among adult survivors of childhood leukemia

Abstract

Keywords

ASJC Scopus subject areas

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