Comparison of Adaptive Functioning Between Survivors of Childhood Acute Lymphoblastic Leukemia and Their Healthy Peers; An Experience from a Low- and Middle-Income Country

Abstract

Introduction: Acute Lymphoblastic Leukemia (ALL) is the most common cancer diagnosed in children. Advances in treatment increased the survival rates of these children. One important long term aspect of survivorship is adaptive functioning, which plays a pivotal role in a child’s quality of life. This study compares the adaptive functions of childhood leukemia survivors with their healthy peers.

Methods: This descriptive case control study was conducted at the Pediatrics Hematology/ Oncology Department of Indus Hospital and Health Network (IHHN), from November 2022 to April 2023. Survivor children and adolescents aged 12 to 18 years old treated for ALL were included. Cases were divided in two groups: Group A, ALL survivors, and Group B, healthy adolescents matched in age to the ALL survivors. VABS assessment was conducted by a qualified psychologist, to evaluate the adaptive functioning. All the information was entered and analyzed by SPSS version 20.

Results: A total of 50 adolescent children were examined along with 50 healthy controls. 72% of the survivors had B-cell ALL (B-ALL), followed by 22% had T-cell ALL (T-ALL) and 6%, had Mixed Phenotype ALL. Mean of adaptive behavior composite score, communication skills, daily living  skills and the socialization skills standard score were significantly lower among patients compared to controls (p=0.0001).

Conclusion: Overall adaptive skills were significantly affected among the survivors. These findings underscore the importance of tailored interventions and support services to enhance the adaptive functioning and overall well-being of these resilient survivors.