Therapeutic adherence to oral medication regimens by adolescents with cancer. II. Clinical and psychologic correlates.

The focus of our study was to identify specific demographic, treatment, and psychologic factors that may differentiate patients who complied with cancer therapy from those who did not. In a companion study, bioassay techniques revealed frequent nonadherence to oral medication regimens among 50 adolescents and young adults with acute lymphoblastic leukemia or Hodgkin disease. In this sample, compliers and noncompliers did not differ with respect to either demographic variables (age, gender) or treatment variables (treatment duration, continuity, complexity, or parental involvement).

Therapeutic adherence to oral medication regimens by adolescents with cancer. I. Laboratory assessment.

Outpatient adherence to oral medication regimens was evaluated in 50 adolescents and young adults with cancer: 21 patients with acute lymphoblastic leukemia or Hodgkin disease who were to take prednisone as a component of their chemotherapy regimen, and 29 patients with Hodgkin disease whose chemotherapy had been discontinued and who were to take penicillin for postsplenectomy prophylaxis. Of the 21 adolescent patients with acute lymphoblastic leukemia or Hodgkin disease who were to take prednisone as outpatients, 11 patients were found to be nonadherent to treatment (52%). Among the 29 adolescents for whom penicillin was prescribed for postsplenectomy prophylaxis, nonadherence was detected in 14 patients (48%).

Children reared in a reverse isolation environment: effects on cognitive and emotional development.

Cognitive and emotional aspects of development in four infants reared in a reverse isolation environment because of congenital severe combined immunodeficiency disease were studied by psychological test performance and formal observation. The children were studied while they were inpatients and following their discharge after successful medical treatment was accomplished. Treatment time in reverse isolation varied from 10 to 52 months.

Language recovery following isolation for severe combined immunodeficiency disease.

Children with congenital severe combined immunodeficiency disease (SCID) lack an immune system and require continuous reverse isolation to protect them from exogenously transmitted infection. In our setting, protected environments consist of laminar flow rooms in which everything is sterilized (food, clothing, toys and so on). Staff and family wear complete surgical garb, preventing skin contact, observation of mouth movement and olfaction of typical human odours.

Immediate and long-term posttherapy neuropsychologic performance in children with acute lymphoblastic leukemia treated without central nervous system radiation.

Intellectual and neuropsychologic test performance was studied in 41 children with acute lymphoblastic leukemia within one year of completing multidrug therapy in which intrathecal methotrexate was the sole agent of central nervous system prophylaxis. To control for possible effects of intensive systemic chemotherapy and the disruptive psychosocial effects of treatment on psychometric test function, 33 children with embryonal rhabdomyosarcoma who had no CNS disease or treatment were similarly studied. All patients studied had been in continuous complete remission since diagnosis.