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Original Article
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Mental status changes after hematopoietic stem cell transplantation†
Article first published online: 23 JUN 2009
DOI: 10.1002/cncr.24496
Copyright © 2009 American Cancer Society
Additional Information
How to Cite
Chang, G., Meadows, M.-E., Orav, E. J. and Antin, J. H. (2009), Mental status changes after hematopoietic stem cell transplantation. Cancer, 115: 4625–4635. doi: 10.1002/cncr.24496
- †
Results based on this study were presented in a poster session at the Annual Meeting of the American Academy of Clinical Neuropsychology, Boston, Massachusetts, June 19-21, 2008.
Publication History
- Issue published online: 17 SEP 2009
- Article first published online: 23 JUN 2009
- Manuscript Accepted: 23 FEB 2009
- Manuscript Revised: 7 JAN 2009
- Manuscript Received: 17 JUL 2008
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Keywords:
- chemobrain;
- hematopoietic stem cell transplantation;
- chronic myelogenous leukemia;
- quality of life;
- memory;
- myelodysplastic syndrome
The overall pattern from measures of neurocognitive function indicated that there were improvements over 18 months in patients who had chronic myelogenous leukemia or myelodysplastic syndrome. When mental status side effects were considered, hematopoietic stem cell transplantation recipients compared favorably with patients who received other treatment.
Abstract
BACKGROUND:
The growing numbers of survivors of innovative cancer treatments, such as hematopoietic stem cell transplantation (HSCT), often report subsequent cognitive difficulties. The objective of this study was to evaluate and compare neurocognitive changes in patients with chronic myelogenous leukemia (CML) or primary myelodysplastic syndrome (MDS) after allogeneic HSCT or other therapies.
METHODS:
In this prospective cohort study, serial evaluations of attention, concentration, memory, mood, and quality of life were used in a consecutive sample of 106 eligible patients who had CML (n = 91) or MDS (n = 15) at enrollment and then 12 months and 18 months after HSCT or other therapy.
RESULTS:
The 3 evaluations at enrollment, 12 months, and 18 months were completed by 98%, 95%, and 89% of surviving participants, respectively. Among all patients, there was significant improvement in memory over 18 months. For example, the 45 patients who underwent HSCT (42 patients with CML and 3 patients with MDS) compared favorably with the patients who received other treatment on most measures of neuropsychological function, except they had improved mental health (P = .034), worse physical function (P = .049), and more difficulty with coordination and fine motor speed bilaterally (dominant hand, P = .005; nondominant hand, P = .0019). Patients with CML overall had improved phonemic fluency (P = .014).
CONCLUSIONS:
The current study indicated that time and diagnosis may be important factors when assessing neurocognitive and other changes. Complaints regarding “chemobrain” after HSCT merit further study, because deficits actually may predate the initiation of treatment and subsequently may improve. The study results could reassure prospective HSCT recipients, because HSCT compared favorably with other treatments when mental status side effects were considered. Cancer 2009. © 2009 American Cancer Society.