{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T17:01:21Z","timestamp":1788627681571,"version":"build-2803163510"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T00:00:00Z","timestamp":1584662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004281","name":"Narodowe Centrum Nauki","doi-asserted-by":"publisher","award":["DEC\u20102012\/05\/N\/NZ5\/00879"],"award-info":[{"award-number":["DEC\u20102012\/05\/N\/NZ5\/00879"]}],"id":[{"id":"10.13039\/501100004281","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of the study was to assess long\u2010term consequences of central nervous system (CNS) prophylaxis in patients with high\u2010risk ALL (HR\u2010ALL) treated according to ALL IC\u2010BFM 2002 and to compare observed abnormalities in patients who underwent allogeneic hematopoietic stem cell transplantation (allo\u2010HSCT) with those who received only prophylactic CNS irradiation (12\u00a0Gy) and with control group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>We studied 29 patients with HR\u2010ALL in CR1 after treatment according to protocol ALL IC\u2010BFM 2002 (14 with allo\u2010HSCT conditioned with fractionated total body irradiation [FTBI] and 15 without HSCT) and 16 children with newly diagnosed ALL (control group). The median time from therapy completion to evaluation was 5 years. To assess brain status, volumetric T1\u2010weighted sequences of magnetic resonance imaging were used. Neuropsychological assessment based on battery neuropsychological tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Transplanted patients had significantly lower volumes of white and gray matter (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.048 and <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) and also of subcortical structures, including the thalamus (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), the hippocampus (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.007), the putamen (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.011), the globus pallidus (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.001), and the accumbens (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). In addition, these patients had generally lower cognitive performance, especially in vocabulary (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.011), visuospatial ability (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.047), executive functions and attention (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.034; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.002; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.048), and processing speed (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.049 and <jats:italic>P<\/jats:italic>\u00a0=\u00a0.037). The thalamus volume is correlated with neuropsychological performance in verbal functions (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), executive functions (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001 and <jats:italic>P<\/jats:italic>\u00a0=\u00a0.024), and processing speed (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In pediatric patients treated for ALL, FTBI\u2010based preparative regimen preceding allo\u2010HSCT causes reduction of subcortical structure volumes and decline in cognitive performance. The observed long\u2010term structural and functional CNS sequelae are significantly more pronounced in transplanted HR\u2010ALL patients than in those treated with prophylactic CNS\u2010 radiotherapy only.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.28224","type":"journal-article","created":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T19:05:37Z","timestamp":1584731137000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Long\u2010term brain status and cognitive impairment in children treated for high\u2010risk acute lymphoblastic leukemia with and without allogeneic hematopoietic stem cell transplantation: A single\u2010center study"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8836-8605","authenticated-orcid":false,"given":"Olga","family":"Zaj\u0105c\u2010Spycha\u0142a","sequence":"first","affiliation":[{"name":"Department of Pediatric Oncology Hematology and Transplantology Poznan University of Medical Sciences  Pozna\u0144 Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8607-0194","authenticated-orcid":false,"given":"Mikolaj A.","family":"Pawlak","sequence":"additional","affiliation":[{"name":"Department of Neurology and Cerebrovascular Disorders Poznan University of Medical Sciences  Pozna\u0144 Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Karmelita\u2010Katulska","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology Poznan University of Medical Sciences  Pozna\u0144 Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakub","family":"Pilarczyk","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology Hematology and Transplantology Poznan University of Medical Sciences  Pozna\u0144 Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Jo\u0144czyk\u2010Potoczna","sequence":"additional","affiliation":[{"name":"Department of Pediatric Radiology Poznan University of Medical Sciences  Pozna\u0144 Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"Przepi\u00f3ra","sequence":"additional","affiliation":[{"name":"Department of Pediatric Radiology Poznan University of Medical Sciences  Pozna\u0144 Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Derwich","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology Hematology and Transplantology Poznan University of Medical Sciences  Pozna\u0144 Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Pieczonka","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology Hematology and Transplantology Poznan University of Medical 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