Cognitive and psychological outcomes of pediatric allogeneic hematopoietic stem cell transplantation survivors in a single center in China

Luo, Yanhui; Yang, Peiyi; Yang, Yuting; He, Peng; Qin, Maoquan; Wang, Bin; Zhu, Guoding; Jia, Chenguang; Yan, Yan; Zhou, Yuchen; Wang, Ruixin; Wang, Aihua; Zhou, Xuan; Xu, Ping

doi:10.1097/md.0000000000017307

Cited by 8 publications

(8 citation statements)

References 30 publications

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“…In certain cancers or hematological disorders, HSCT may be considered as the only viable treatment option after treatment failures or disease relapse. Therefore, these children might suffer from poorer psychosocial outcomes as they tended to be sicker, have prolonged periods of hospitalization, and suffer from more severe chronic complications such as graft-versus-host disease [ 19 , 46 ]. Future work should also compare functioning in HSCT recipients treated with reduced intensive conditioning versus myeloablative conditioning as some groups have reported better quality of life in the former group [ 51 , 52 ].…”

Section: Discussionmentioning

confidence: 99%

Psychosocial outcomes in Chinese survivors of pediatric cancers or bone marrow failure disorders: A single-center study

et al. 2022

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Background/Objectives Most of the studies on functional outcomes in pediatric survivors of cancers and bone marrow failure disorders have been conducted in North American, European, and Oceanian populations, with few studies having been performed in China. The objective of this study was to evaluate psychosocial outcomes in a cohort of Chinese pediatric survivors diagnosed with cancer or conditions requiring hematopoietic stem cell transplantation (HSCT), and to identify clinical and behavioral factors associated with adverse psychosocial outcomes. Methods This was a cross-sectional survey study. We recruited pediatric survivors of cancer or inherited disorder requiring HSCT at ≤18 years old and were ≥6 months post-treatment. Parents completed the St. Jude Children’s Research Hospital After Completion of Therapy questionnaire to report their child’s emotional functioning, social functioning, attention/concentration and behavior. Multivariable general linear modeling was used to identify clinical, treatment and behavioral factors associated with psychosocial outcomes, adjusting for sex, age and cancer diagnoses. Results Ninety-five pediatric survivors were recruited (62.1% male; mean [standard deviation] age 9.7 [3.4] years; 4.1 [2.6] years post-diagnosis). They were diagnosed with bone marrow failure disorders (23.2%), hematological malignancies (45.3%) or solid tumors (23.2%). Compared with survivors with no current health problems, those with more than one current health problem performed worse in emotional functioning (Estimate = 2.42, SE = 0.88, P = 0.008) and social functioning (Estimate = 2.90, SE = 1.64, P = 0.03). Higher pain interference was significantly associated with worse emotional functioning (Estimate = 0.19, SE = 0.08, P = 0.03) and attention functioning (Estimate = 0.26, SE = 0.11, P = 0.03). Compared with survivors who reported less sleep problems, those who had more sleep problems demonstrated poorer emotional functioning (Estimate = 0.30, SE = 0.08, P = 0.001). Survivors who had a longer duration of screen usage per day reported more impairment on attention and behavior functioning than those who had a shorter duration of screen usage per day (both P<0.5). Conclusion Survivors who were diagnosed at a younger age or had unaddressed/untreated health problems may require additional psychological evaluation. The implementation of psychosocial assessments during routine long-term follow-up care may help to identify high-risk patients during the early phase of survivorship. Rehabilitation interventions should address modifiable behavioral factors (e.g. sleep habits, screen time and chronic pain).

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Section: Discussionmentioning

confidence: 99%

Psychosocial outcomes in Chinese survivors of pediatric cancers or bone marrow failure disorders: A single-center study

et al. 2022

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“…A recent study found that 16% of pedi at ric HCT sur vi vors endorsed depres sion, whereas 10% of sur vi vors endorsed anx i ety. 28 Neurocognitive dys function is prev a lent in about 50% of pedi at ric HCT sur vi vors. 28 The domain of motor devel op ment was affected to the greatest extent; how ever, lan guage, social, and emo tional devel op ment was also impaired com pared to healthy peers.…”

Section: Specific Con Sid Er Ations For Pedi At Ric/aya Pop U La Tionsmentioning

confidence: 99%

“…28 Neurocognitive dys function is prev a lent in about 50% of pedi at ric HCT sur vi vors. 28 The domain of motor devel op ment was affected to the greatest extent; how ever, lan guage, social, and emo tional devel op ment was also impaired com pared to healthy peers. AYA sur vi vors of HCT are a unique pop u la tion that require spe cial care con sid er ations.…”

Section: Specific Con Sid Er Ations For Pedi At Ric/aya Pop U La Tionsmentioning

confidence: 99%

Psychosocial and financial issues after hematopoietic cell transplantation

Buchbinder

Khera

2021

Hematology

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With improvement in survival after hematopoietic cell transplantation (HCT), it has become important to focus on survivors' psychosocial issues in order to provide patient-centered care across the transplant continuum. The goals of this article are to describe updates in the literature on certain psychosocial domains (emotional/mental health and social/financial) in HCT survivors, offer a brief overview of the status of the screening and management of these complications, and identify opportunities for future practice and research. An evidence-based approach to psychosocial care can be broken down as primary (promoting health, raising awareness, and addressing risk factors), secondary (screening and directing early pharmacological and nonpharmacological interventions), and tertiary (rehabilitating, limiting disability, and improving quality of life) prevention. Implementing such an approach requires close coordination between multiple stakeholders, including transplant center staff, referring hematologist/oncologists, and other subspecialists in areas such as palliative medicine or psychiatry. Innovative models of care that leverage technology can bring these stakeholders together to fulfill unmet needs in this area by addressing barriers in the delivery of psychosocial care.

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“…Allogeneic hematopoietic stem cell transplantation (allo‐HSCT) is an effective and curative treatment for several types of malignant and non‐malignant hematologic diseases, immunologic deficiency diseases, and inherited metabolic disorders for many children and adolescents 1,2 …”

Section: Introductionmentioning

confidence: 99%

“…Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an effective and curative treatment for several types of malignant and non-malignant hematologic diseases, immunologic deficiency diseases, and inherited metabolic disorders for many children and adolescents. 1,2 Chemotherapy and/or radiotherapy in high doses are used in preparative or conditioning regimes for them. These regimens, as well as other treatments before and after HSCT such as immunosuppressive drugs to prevent graft-versus-host disease (GvHD), may affect the patient's organs and tissues and may cause both acute and long-term complications.…”

Section: Introductionmentioning

confidence: 99%

Impact of allogeneic stem cell transplantation in childhood and adolescence on quality of adulthood life: A case–control study

Silva

Orlandini

Paz

et al. 2022

Pediatric Transplantation

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Background Allogeneic hematopoietic stem cell transplantation (allo‐HSCT) is associated with late complications that can impair the quality of life (QoL) of patients for years after transplant. The purpose of the present study was to determine the difference in the QoL of adults that underwent allo‐HSCT in childhood and adolescence compared with not transplanted adults. Methods In this prospective case–control cross‐sectional study, we included patients aged ≥18 years that received an allo‐HSCT during childhood or adolescence and subsequently survived at least 2 years after transplantation. The control group consisted of blood donors matched for age and sex. QoL assessment was performed using the Short Form‐36 (SF‐36) Health Survey, Portuguese version 2. Results Thirty‐four transplanted patients and controls were included. 58.8% were male, and the median age at transplant was 13.5 years (range, 4–17 years). The median follow‐up was 11.5 years (range, 2.0–23.0 years). The most common late effect was skeletally followed by endocrine complications. Patients with these late complications had the worst QOL in the following dimensions: physical functioning, role physical, bodily pain, general health, and mental health. When compared to the control group, patients had a lower score in two dimensions: physical functioning and role physical. Conclusions Although skeletal and endocrine complications of transplant patients in childhood have an impact on physical functioning, most parameters of QoL of these patients in adulthood are similar to healthy individuals of the same age and gender. Early detection and long‐term monitoring of late complications can prevent impairment of the QoL.

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Cognitive and psychological outcomes of pediatric allogeneic hematopoietic stem cell transplantation survivors in a single center in China

Cited by 8 publications

References 30 publications

Psychosocial outcomes in Chinese survivors of pediatric cancers or bone marrow failure disorders: A single-center study

Psychosocial outcomes in Chinese survivors of pediatric cancers or bone marrow failure disorders: A single-center study

Psychosocial and financial issues after hematopoietic cell transplantation

Impact of allogeneic stem cell transplantation in childhood and adolescence on quality of adulthood life: A case–control study

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