Acute lymphoblastic leukemia often affects which cognitive domains?

• A. Overall IQ and attention
• B. Processing speed, attention and memory
• C. Visual-spatial, working memory, and peripheral neuropathy, and attention
• D. Processing speed, attention, working memory, but not memory

Answer: (B)

The pattern most often seen after treatment for acute lymphoblastic leukemia involves slowed processing speed with difficulties in attention and memory. CNS-directed therapies (like intrathecal chemotherapy or cranial irradiation) can disrupt rapid information processing and the networks that support sustained attention, while also impacting short-term and working memory. Because overall IQ is frequently preserved in these patients, the emphasis is on how quickly information is taken in, kept, and manipulated rather than on a global drop in intelligence. Choices that emphasize peripheral neuropathy or visual-spatial skills as primary cognitive domains miss the central profile, and omitting memory would overlook a core area commonly affected.