Chemotherapy-Related Differences in Cognitive Functioning and Their Biological Predictors in Patients with Multiple Myeloma

Abstract

The paper presents a study on the changes in cognitive functioning in patients undergoing chemotherapy with diagnosed multiple myeloma (MM). The aim of the study was to answer the following two main research questions: Does the treatment stage differentiate the functioning of cognitive processes in patients with diagnosed MM and to what extent? Is it possible to treat biological factors (TNF-α, IL-6, IL-10, and BDNF) as predictors of patients’ cognitive functioning? The patients were examined twice, before the treatment and after 4–6 cycles of chemotherapy. Selected neuropsychological research methods as well as experimental and clinical trials were employed to diagnose the patients’ general cognitive state, attention, memory, and executive functions. The level of biological factors was assessed with the ELISA test. The results show that the patients’ cognitive functioning was worse before the treatment than during the cytostatic therapy. It was also possible to predict the cognitive state of patients suffering from multiple myeloma based on a selected biological parameter (neurotrophin BDNF).

BDNF Augmentation Using Riluzole Reverses Doxorubicin-Induced Decline in Cognitive Function and Neurogenesis

“…Several human studies have reported a positive correlation between BDNF levels and improved cognitive function in cancer patients [44], supporting our hypothesis that augmenting BDNF has great potential to mitigate CRCI. Hence, the basis of this study stems from the breadth of our and others' clinical data showing a positive correlation between the low BDNF levels with cognitive dysfunction in cancer patients receiving cytotoxic chemotherapy [3][4][5][6][7]. We postulated that the effects of chronic chemotherapy on BDNF expression could persist long after the completion of chemotherapy and in cancer survivors, resulting in the long-term CRCI [14].…”

“…Clinical studies have suggested that brain-derived neurotrophic factor (BDNF) is linked with a positive impact on cognition in patients with cancer [3][4][5][6][7]. BDNF exerts a number of neuro-modulatory effects on the CNS and the neurosensory, endocrine, and immune systems, and BDNF is also associated with neuronal repair and survival, dendritic and axonal growth, and long-term potentiation.…”

Brain-derived neurotrophic factor as a biomarker in cancer-related cognitive impairment among adolescent and young adult cancer patients

“…As in vivo quantification of brain BDNF is impossible, clinical studies have largely utilized serum or plasma levels of BDNF as a surrogate of brain BDNF levels 9 . Our systematic review 10 found consistent relationships between higher blood-derived BDNF levels and improved cognitive function among cancer patients with breast cancer 11 , lymphoma 12 , multiple myeloma 13 , hepatocellular carcinoma 14 , and metastatic cancers 15 . Val66Met (rs6265), a single nucleotide polymorphism of the BDNF gene, is increasingly recognized as a possible predictive biomarker of CRCI and other neurodegenerative diseases.…”

Neuroimaging and Neurocognitive Outcomes in Older Patients with Multiple Myeloma Treated with Chemotherapy and Autologous Stem Cell Transplantation

“…There is a limited number of neurocognitive studies focusing on MM patients. Some studies have reported improvement in NF following chemotherapy in older MM patients (Bury-Kaminska, 2021) [ 9 ] and one-year post-SCT in a sample of mostly MM patients (Jacobs et al, 2007) [ 10 ]. However, neurocognitive dysfunction has been reported in MM patients (mean age = 58 years, SD = 8.2) after HDC and pre-ASCT, with declines one and three months post-HDC/ASCT [ 8 ].…”

“…Neurocognitive dysfunction has been documented in multiple myeloma (MM) patients after HDC and pre-autologous SCT (ASCT), with declines post-HDC/ASCT [ 8 ]; however, other studies have reported improvements in neurocognitive function (NF) months post-chemotherapy [ 9 , 10 ]. Pro-inflammatory cytokines (PCy) play a critical role in tumor growth and progression in MM, with high levels identified in many patients [ 11 ].…”