Characteristics and correlates of cognitive functioning following bone marrow transplantation

Abstract

Summary:Patients who undergo bone marrow transplantation (BMT) often report cognitive problems following treatment. This study used cognitive tests and a self-report measure of subjective cognitive complaints to determine (1) the rate of objective cognitive impairment in a sample of 65 BMT patients, and (2) the correspondence of patients' cognitive complaints to their actual cognitive performance. At 6 months following BMT, patients were assessed in seven cognitive domains -attention, verbal learning, verbal memory, visual memory, simple executive function, complex executive function, and psychomotor speed. Cognitive complaints were likewise assessed. In all, 51% had at least mild impairment (À1 standard deviation (s.d.) below published norms) in one or more cognitive domains, with 28% demonstrating moderate-to-severe impairment (À2 s.d.). Older patients and patients with lower IQ were more likely to score in the impaired range on objective cognitive tests, with males and the less educated showing trends toward scores in the impaired range. Younger patients made significantly more cognitive complaints. Total cognitive complaints were unrelated to average cognitive performance, and complaints in specific cognitive domains were largely unrelated to objective performance on corresponding domains. Findings suggest that patients who complain about their cognitive performance following BMT differ from those who experience actual deficits. Bone Marrow Transplantation (2005) 36, 695-702.

Social outcome in children treated by haematopoietic cell transplant for congenital immunodeficiency

“…2 Studies to date have mostly used measures of general cognitive ability (for example, intelligence quotient (IQ)) rather than measuring specific cognitive functions, but it has been suggested that the executive functions of attention, concentration and working memory may be particularly associated with social difficulties. 5,12 Executive dysfunction has been shown to be the most frequent cognitive impairment in adult HCT survivors, 13,14 but has not yet been investigated in children. In addition, executive abilities and social function have been shown to be associated in childhood psychiatric disorders, such as attention deficit hyperactivity disorder, 15 conduct disorder 16 and autism.…”

Rehabilitation of therapy-related cognitive deficits in patients after hematopoietic stem cell transplantation

“…The deficits in psychomotoric skills persisted until the third measurement, which the authors associated with chronic graft-versus-host disease (GvHD) and the longterm immunosuppression associated therewith. BoothJones et al 39 examined 65 patients 6 months after HSCT, finding at least mild cognitive deficits in 51% and moderate-to-severe impairment in 28%. The predictors for impaired neuropsychological test performance were lower premorbid intelligence and advanced age.…”

Successful treatment of stress-induced cognitive impairment with haloperidol; evaluation also warranted in hematopoietic stem cell transplantation

“…In survivors by time improvement spontaneously occurs but generally not to the norm observed in healthy subjects. Also in other cancers than hematological malignancies cognitive impairment after treatment has been reported [5,13,14].…”

“…Booth-Jones et al, examined 65 patients with breast cancer, leukemia, lymphoma and multiple myeloma 6 months after transplantation in seven cognitive domains, including attention, verbal learning, verbal memory, visual memory, simple executive function, complex executive function and psychomotor speed [5]. 51% had mild cognitive impairment and 28% moderate or severe impairment.…”