Purpose/objectives

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

Design

A prospective, repeated-measures design
.

Setting

Two pediatric oncology settings in the southwestern United States.

Sample

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

Methods

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
.

Findings

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
.

Conclusions

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.