نبذة مختصرة : Background: As the survival rates of pediatric malignancies increased, many survivors experienced various long-term effects. Cognitive dysfunction may be one of the hazardous late effects among this critical age group. This study aimed to evaluate the cognitive functions, brain volume, and risk factors affecting them among survivors of hematological malignancies. Methods: This case-control study was conducted on 68 survivors of hematological malignancies, with a mean follow-up period 2.1± 1.2 years (ranged from 1 to 6.2 years). Age and sex-matched 68 child were selected as a comparison group. Detailed clinical and therapeutic data were collected from patients’ records. Assessment of cognitive function was done using Arabic version of the Stanford-Binet Test (version IV). Quantitative volumetric assessment of the brain was done using the NeuroQuant study (NQ). Results: The cancer survivors showed significantly lower levels in IQ and their subitems than the control group. Brain atrophy was observed in the NQ impression in the majority of our survivors. AML survivors had significantly lower volumes of thalami, white matter, and hippocampus than other survivors. Many risk factors had a significantly adverse effect on different IQ subitems, such as radiotherapy (RTH), high cumulative doses of methotrexate (MTX), and prednisone. While low white matter volume (WMV) was observed with higher mean cumulative doses of MTX and anthracyclines. Conclusions: Survivors of pediatric hematological malignancies showed significant cognitive impairment, this can be attributed to neuronal degeneration (brain volume loss). RTH, high cumulative doses of MTX and steroids were the most prominent risk factors.
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