{"doi":"10.1177/1043454220909785","title":"The Longitudinal Parallel Process Analysis of Biomarkers of Oxidative Stress, Symptom Clusters, and Cognitive Function in Children With Leukemia","abstract":"Background: During treatment for acute lymphoblastic leukemia (ALL), children report co-occurring symptoms of fatigue, sleep disturbance, pain, nausea, and depression as a symptom cluster. Central nervous system–directed ALL therapies also put children at risk for cognitive impairments. Cancer therapies can cause an increase in oxidative stress, which may contribute to treatment-related symptoms. This study examined the longitudinal relationships between biomarkers of oxidative stress in the cerebrospinal fluid, the Childhood Cancer Symptom Cluster–Leukemia (CCSC-L), and cognition, in children over the first year of ALL treatment. Methods: Glutathione (GSH) biomarkers of oxidative stress were measured in cerebrospinal fluid collected during treatment lumbar punctures. GSH biomarkers, symptoms, and cognitive function of 132 children aged 3 to 18 years were evaluated at four time points during the first year of leukemia treatment. Participants, 7 years and older, completed self-report measures, and parents reported for younger children. Cognitive function measurements for all participants were completed by parents. A longitudinal parallel-process model was used to explore the influence of the initial measurement and the subsequent change over four time points of the GSH biomarkers on the CCSC-L and cognition. Results: GSH biomarkers increased over the four time points indicating decreasing oxidative stress. When GSH biomarkers were higher (less oxidative stress) at the initial measurement, the CCSC-L severity was lower, cognition was better, and cognition improved over the four measurements. Screening children for high levels of oxidative stress would be a foundation for future intervention studies to address symptom distress and cognitive impairments.","journal":"Journal of Pediatric Oncology Nursing","year":2020,"id":79284,"datarank":0.42498200160843247,"base_score":2.833213344056216,"endowment":2.833213344056216,"self_citation_contribution":0.42498200160843247,"citation_network_contribution":0.0,"self_endowment_contribution":0.42498200160843247,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":16,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9538,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":347428,"name":"Daniel Hatch","orcid":"0000-0003-0220-7059","position":1,"is_corresponding":false},{"id":411881,"name":"Marilyn Hockenberry","orcid":"0000-0002-3456-3763","position":2,"is_corresponding":false},{"id":412849,"name":"Susan A. Whitman","orcid":null,"position":3,"is_corresponding":false},{"id":412850,"name":"Ida M. Moore","orcid":null,"position":4,"is_corresponding":false},{"id":228871,"name":"David W. Montgomery","orcid":"0000-0001-8112-8695","position":5,"is_corresponding":false},{"id":411882,"name":"Kari Marano","orcid":"0000-0002-0661-3858","position":6,"is_corresponding":false},{"id":412851,"name":"Pauline Mitby","orcid":null,"position":7,"is_corresponding":false},{"id":247449,"name":"Michael E. Scheurer","orcid":"0000-0002-8379-6088","position":8,"is_corresponding":false},{"id":412852,"name":"Olga A. Taylor","orcid":null,"position":9,"is_corresponding":false},{"id":411883,"name":"Wei Pan","orcid":"0000-0003-2410-9935","position":10,"is_corresponding":false},{"id":411880,"name":"Mary C. Hooke","orcid":"0000-0002-6137-9224","position":0,"is_corresponding":true}],"reference_count":39,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-18T21:50:33.748601Z","pmid":"32141369","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}