The aim of the study was to assess cognitive performance in patients with hematological malignancies before, and 3 months after, allogeneic hematopoietic stem cell transplant (HSCT). A consecutive sample of 39 patients was assessed before admission with a comprehensive neuropsychological test battery and health-related quality-oflife (HRQoL) questionnaires; 19 of these patients were retested around 100 days post HSCT. Test results were compared with normative data and revealed minimal differences at both time points in the level of group-means. One parameter -simple reaction time -was significantly worse (prolonged) at second measurement after HSCT. According to the definition of an impairment score (more than three impaired functions), 26% of patients were classified as impaired before as well as after HSCT. Neuropsychological test results did not vary systematically according to medical variables such as extent of pretreatment, graft-versus-host-disease (GvHD) and kind of conditioning protocol. As a dimension of HRQoL, selfrated cognitive function was in the normal range before and after HSCT. Significant correlations between HRQoL and neuropsychological parameters were related to symptom scales. This study showed impairments of neuropsychological performance for a subgroup of patients before and after allogeneic HSCT. Systematic effects of conditioning, medical variables or self-rated HRQoL could not be observed.
Five years after treatment, standard-dose patients were slightly, but not significantly, more impaired in cognitive performance than high-dose patients.
Die in mehreren Studien gefundenen kognitiven Störungen bei Tumorpatienten nach Chemotherapie werden zumeist mit der Zytostatikaneurotoxizität assoziiert. In der vorliegenden Arbeit wird der Zusammenhang von Angst, Depression und Posttraumatischer Belastungsstörung mit der kognitiven Leistungsfähigkeit bei Frauen mit Mammakarzinom untersucht. Insgesamt wurden 76 Brustkrebspatientinnen fünf Jahre nach Abschluss der onkologischen Behandlung mit neuropsychologischen Testverfahren sowie mit der Hospital Anxiety and Depression Scale – Deutsche Version (HADS-D) und der Posttraumatic Stress Disorder Checklist – Civilian Version (PCL-C) untersucht: 23 nach Standard- und 24 nach Hochdosistherapie sowie 29 nach Brustoperation und Strahlentherapie als Vergleichsgruppe. Signifikante Zusammenhänge sind vor allem zwischen kognitiven Funktionen und Intrusionssymptomen einer Posttraumatischen Belastungsstörung (PTBS) festzustellen. Bei Patientinnen nach Standardtherapie weisen Intrusionen der PTBS einen moderaten Zusammenhang mit der globalen kognitiven Beeinträchtigung auf. Die Ergebnisse der Studie deuten auf multidimensionale Einfluss- und moderierende Faktoren bei der Entwicklung kognitiver Defizite bei Brustkrebspatientinnen nach onkologischer Therapie hin.
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