Oxidative Stress, Motor Abilities, and Behavioral Adjustment in Children Treated for Acute Lymphoblastic Leukemia.

Journal Article (Journal Article)


To examine associations among oxidative stress, fine and visual-motor abilities, and behavioral adjustment in children receiving chemotherapy for acute lymphoblastic leukemia (ALL)


A prospective, repeated-measures design


Two pediatric oncology settings in the southwestern United States.


89 children with ALL were followed from diagnosis to the end of chemotherapy.


Serial cerebrospinal fluid samples were collected during scheduled lumbar punctures and analyzed for oxidative stress biomarkers. Children completed fine motor dexterity, visual processing speed, and visual-motor integration measures at three time points. Parents completed child behavior ratings at the same times.

Main research variables

Oxidative stress, fine motor dexterity, visual processing, visual-motor integration, and behavioral adjustment


Children with ALL had below-average fine motor dexterity, visual processing speed, and visual-motor integration following the induction phase of ALL therapy. By end of therapy, visual processing speed normalized, and fine motor dexterity and visual-motor integration remained below average. Oxidative stress measures correlated with fine motor dexterity and visual-motor integration. Decreased motor functioning was associated with increased hyperactivity and anxiety


Oxidative stress occurs following chemo-therapy for childhood ALL and is related to impaired fine motor skills and visual symptoms

Implications for nursing

Early intervention should be considered to prevent fine motor and visual-spatial deficits, as well as behavioral problems.

Full Text

Duke Authors

Cited Authors

  • Hockenberry, MJ; Krull, KR; Insel, KC; Harris, LL; Gundy, PM; Adkins, KB; Pasvogel, AE; Taylor, OA; Koerner, KM; Montgomery, DW; Ross, AK; Hill, A; Moore, IM

Published Date

  • September 2015

Published In

Volume / Issue

  • 42 / 5

Start / End Page

  • 542 - 549

PubMed ID

  • 26302283

Pubmed Central ID

  • PMC4551112

Electronic International Standard Serial Number (EISSN)

  • 1538-0688

International Standard Serial Number (ISSN)

  • 0190-535X

Digital Object Identifier (DOI)

  • 10.1188/15.onf.542-549


  • eng