Cognitive and psychosocial functioning of pediatric hematopoietic stem cell transplant patients: A prospective longitudinal study

Abstract

Summary:A prospective longitudinal study of cognitive and psychosocial functioning in pediatric hematopoietic stem cell transplant (HSCT) patients was conducted on three occasions: pre-HSCT, 1 year post-HSCT, and 2 years post-HSCT. In contrast to the previous hypothesis that cognitive declines would occur as a result of HSCT treatment, it was hypothesized that (1) global cognitive functioning (IQ scores), as well as specific areas would remain stable over time; (2) pre-transplant functioning would be predictive of later functioning; and (3) age would be negatively related to cognitive functioning. Based on previous research it was further hypothesized: that (4) while declines in psychosocial functioning might be seen at 1 year, functioning would improve by 2 years. 153 children and adolescents were evaluated pre-HSCT and at 1 year, with 2 year data available for 74 children. Advances in pediatric hematopoietic stem cell transplantation (HSCT) have resulted in increased survival and greater attention to long-term effects of treatment. Mortality remains relatively high in this population, however, and accumulation of data from a sufficient number of patients who survive this treatment involves many years. As a result, our understanding of the cognitive and behavioral Correspondence: MJ Kupst,

Health-related quality of life in survivors of BMT for paediatric malignancy: a systematic review of the literature

“…Two studies (combined N ¼ 200), included detailed information about ethnic group. 16,17 Of these, 85% were Caucasian, 7.5% Black African Caribbean or Jamaican, 4.5% Hispanic, 0.5% Asian and 2.5% described as other or mixed background.…”

“…18,26,27,21 Informal measures of HRQL were also employed. Formal measures of behavioural and social functioning, cognitive function and IQ, individual 41 BMT specific Helder et al 26 Modified version of the Standford Health Questionnaire 42 BMT specific Badell et al 27 DSII-HSCT 10 BMT specific Parsons et al 21 Behavioural and social functioning Rutter scales for parent and teacher 43 Generic Arvidson et al 24 Child Behaviour Checklist 44 Generic Arvidson et al 24 Barrera et al 25 Phipps and Mulhern 7 Simms et al 17 Kupst et al 16 Vineland Adaptive Behaviour Scales 45 Generic Barrera et al 25 Kupst et al 16 The Youth Self-Report 46 Generic Simms et al 17 Individual/personality characteristics Piers-Harris Self-Concept Scale 57 Generic Phipps and Mulhern 7 'I think I am' (Swedish measure of self-esteem) 58 Generic Arvidson et al 24 Forinder et al 22,23 Sense of coherence (Swedish measure of tendency to view life as meaningful) 59 Generic Forinder et al 22 and personality characteristics, emotional functioning, symptoms and physical activity were identified in addition to HRQL. Formal assessments of parental anxiety, 25 depression, 25 HRQL, 21 family environment 7 and adaptability and cohesiveness 25 were also reported.…”

“…7,[16][17][18]21,25,28 Sample size ranged from 22 26 to 160 21 and involved 988 children. Age at assessment was 7-32 years for crosssectional studies, and 19 months (pre-) to 23 years (post transplant) for longitudinal research.…”

“…24 Treatment involved BMT for six cohorts, 7,18,[24][25][26][27] BMT or PBSC transplant for two 22,28 and SCT, not further specified, in four. 16,17,21,29 One or more standardized measure of HRQL (Table 3) was used in eight studies, 18,21,22,[25][26][27][28][29] but these included 12 different measures. Six generic and five cancer-specific measures were used.…”

“…We refer to the article most relevant to psychosocial outcomes for the purpose of this review. Studies were conducted in the US, 7,[16][17][18][19][20][21] Sweden, [22][23][24] Canada, 25 Netherlands, 26 Spain, 27 Austria 28 and France. 29 All but three 21,28,29 were single centre studies.…”