急性淋巴细胞白血病 (ALL) 约占儿科癌症的 25%，按照现代方案，5 年生存率超过 90%。尽管生存率有所提高，但治疗带来的神经认知损伤仍引起人们的担忧。这项登记研究旨在探讨 ALL 治疗对瑞典儿童九年级教育成果的影响。从瑞典儿童癌症登记处确定了一个由 1990 年至 2010 年诊断为 ALL 的 503 名儿童组成的人群队列，每个队列与 5 个对照进行匹配。评估变量包括延迟毕业、高中资格、总成绩、瑞典语、英语、数学和体育成绩以及国家考试成绩。在病例和对照之间并按性别、诊断时年龄和风险组进行分析。我们的结果显示，与对照组相比，病例延迟毕业的几率更高，体育成绩较差，并且在英语和数学国家考试中缺席率更高。标准风险组的儿童（仅接受一线化疗）表现出与匹配对照相似的结果，而高风险组的儿童（接受颅脑照射、血液干细胞移植或/和 ALL 复发治疗，因此可能与对照组相比，还接受放射治疗的患者的总价值较低。我们得出的结论是，1990 年至 2010 年间被诊断患有 ALL 的瑞典儿童主要表现出与对照组相当的教育成果，尽管高危组儿童的教育成果较低。这些发现强调了评估特别是患有高危 ALL 的儿童的重要性，以便确定那些需要教育支持的儿童并设计有针对性的干预措施。© 2024 作者。约翰·威利出版的《国际癌症杂志》

Acute lymphoblastic leukemia (ALL) constitutes approximately 25% of pediatric cancers, and with contemporary protocols, the 5-year survival rate is over 90%. Despite improved survival, neurocognitive impairments from treatment raise concerns. This registry study aimed to explore the impact of ALL treatment on educational outcomes from school year nine in Swedish children. A population-based cohort of 503 children diagnosed with ALL from 1990 to 2010 was identified from the Swedish Childhood Cancer Registry and matched with five controls each. Assessed variables were delayed graduation, high school eligibility, total merit value, school grades in Swedish, English, mathematics, and physical education, and results in national tests. Analyses were performed between cases and controls and by sex, age at diagnosis, and risk group. Our results showed that, compared to controls, cases had higher odds for delayed graduation, poorer results in physical education, and higher rates of absence in national tests in English and mathematics. Children in the standard-risk group (treated with first-line chemotherapy only) exhibited similar results to matched controls whereas children in the high-risk group (treated with cranial irradiation, hematological stem cell transplantation, or/and for ALL relapse and thus likely received also radiotherapy) had lower total merit value compared to controls. We conclude that Swedish children diagnosed with ALL between the years 1990-2010 mainly exhibited comparable educational outcomes to controls, although children in the high-risk group had lower results. These findings highlight the importance of evaluating especially children with high-risk ALL in order to identify those requiring educational support and for designing targeted interventions.© 2024 The Author(s). International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.