BACKGROUND: Few studies have examined the acute effects of autologous hematopoietic stem cell transplantation (Au-HSCT) on the neuropsychological functioning of patients with multiple myeloma (MM). The prevalence of cognitive deficits after induction chemotherapy (pre-AuHSCT) was examined in patients with MM, clinically significant changes in cognitive function 1 and 3 months post-AuHSCT were determined, and patients who may be vulnerable to cognitive decline during this period were identified. METHODS: A total of 53 patients with MM were recruited pre-AuHSCT. Neuropsychological tests measuring multiple cognitive domains (attention, psychomotor speed, learning/memory, language, executive function, motor function) were administered pre-AuHSCT and 1 and 3 months post-AuHSCT. A pretreatment assessment was not available. An Overall Cognitive Function Index was computed to determine cognitive impairment pre-AuHSCT, and a practice-effect-adjusted Reliable Change Index was used to determine cognitive change over time. RESULTS: Overall, deficits were more frequent in learning/memory, executive function, motor function, and psychomotor speed. Before AuHSCT, 47% of patients (25/53) exhibited cognitive impairment as determined by the Overall Cognitive Function Index. One month post-AuHSCT, 49% of patients (20/41) demonstrated clinically significant decline on 1 or more measures; 3 months post-AuHSCT, 48% (14 of 29 patients) showed decline on 1 or more measures. Older patients, minorities, and those with advanced disease, more induction cycles, or postinduction deficits showed greater vulnerability to decline. CONCLUSIONS: Nearly half of the patients showed vulnerability to impairment in learning/memory or executive function after receiving induction therapy, and the prevalence of impairment remained high post-AuHSCT. Awareness of cognitive impairment and associated risk factors in actively treated patients is important for considering psychosocial or other support for patients with acute cognitive symptoms.
BACKGROUND: Few studies have examined the acute effects of autologous hematopoietic stem cell transplantation (Au-HSCT) on the neuropsychological functioning of patients with multiple myeloma (MM). The prevalence of cognitive deficits after induction chemotherapy (pre-AuHSCT) was examined in patients with MM, clinically significant changes in cognitive function 1 and 3 months post-AuHSCT were determined, and patients who may be vulnerable to cognitive decline during this period were identified. METHODS: A total of 53 patients with MM were recruited pre-AuHSCT. Neuropsychological tests measuring multiple cognitive domains (attention, psychomotor speed, learning/memory, language, executive function, motor function) were administered pre-AuHSCT and 1 and 3 months post-AuHSCT. A pretreatment assessment was not available. An Overall Cognitive Function Index was computed to determine cognitive impairment pre-AuHSCT, and a practice-effect-adjusted Reliable Change Index was used to determine cognitive change over time. RESULTS: Overall, deficits were more frequent in learning/memory, executive function, motor function, and psychomotor speed. Before AuHSCT, 47% of patients (25/53) exhibited cognitive impairment as determined by the Overall Cognitive Function Index. One month post-AuHSCT, 49% of patients (20/41) demonstrated clinically significant decline on 1 or more measures; 3 months post-AuHSCT, 48% (14 of 29 patients) showed decline on 1 or more measures. Older patients, minorities, and those with advanced disease, more induction cycles, or postinduction deficits showed greater vulnerability to decline. CONCLUSIONS: Nearly half of the patients showed vulnerability to impairment in learning/memory or executive function after receiving induction therapy, and the prevalence of impairment remained high post-AuHSCT. Awareness of cognitive impairment and associated risk factors in actively treated patients is important for considering psychosocial or other support for patients with acute cognitive symptoms.
Authors: Jeffrey S Wefel; Renato Lenzi; Richard Theriault; Aman U Buzdar; Scott Cruickshank; Christina A Meyers Journal: Cancer Date: 2004-08-01 Impact factor: 6.860
Authors: Debra Lynch Kelly; David Buchbinder; Rafael F Duarte; Jeffrey J Auletta; Neel Bhatt; Michael Byrne; Zachariah DeFilipp; Melissa Gabriel; Anuj Mahindra; Maxim Norkin; Helene Schoemans; Ami J Shah; Ibrahim Ahmed; Yoshiko Atsuta; Grzegorz W Basak; Sara Beattie; Sita Bhella; Christopher Bredeson; Nancy Bunin; Jignesh Dalal; Andrew Daly; James Gajewski; Robert Peter Gale; John Galvin; Mehdi Hamadani; Robert J Hayashi; Kehinde Adekola; Jason Law; Catherine J Lee; Jane Liesveld; Adriana K Malone; Arnon Nagler; Seema Naik; Taiga Nishihori; Susan K Parsons; Angela Scherwath; Hannah-Lise Schofield; Robert Soiffer; Jeff Szer; Ida Twist; Anne Warwick; Baldeep M Wirk; Jean Yi; Minoo Battiwalla; Mary E Flowers; Bipin Savani; Bronwen E Shaw Journal: Biol Blood Marrow Transplant Date: 2017-09-20 Impact factor: 5.742
Authors: Jennifer N Vega; Kimberly M Albert; Ingrid A Mayer; Warren D Taylor; Paul A Newhouse Journal: J Cancer Surviv Date: 2019-07-23 Impact factor: 4.442
Authors: Aasha I Hoogland; Ashley M Nelson; Brian D Gonzalez; Brent J Small; Elizabeth C Breen; Steve K Sutton; Karen L Syrjala; Julienne E Bower; Joseph Pidala; Margaret Booth-Jones; Paul B Jacobsen; Heather S L Jim Journal: Brain Behav Immun Date: 2019-04-03 Impact factor: 7.217
Authors: David Buchbinder; Debra Lynch Kelly; Rafael F Duarte; Jeffery J Auletta; Neel Bhatt; Michael Byrne; Zachariah DeFilipp; Melissa Gabriel; Anuj Mahindra; Maxim Norkin; Helene Schoemans; Ami J Shah; Ibrahim Ahmed; Yoshiko Atsuta; Grzegorz W Basak; Sara Beattie; Sita Bhella; Christopher Bredeson; Nancy Bunin; Jignesh Dalal; Andrew Daly; James Gajewski; Robert Peter Gale; John Galvin; Mehdi Hamadani; Robert J Hayashi; Kehinde Adekola; Jason Law; Catherine J Lee; Jane Liesveld; Adriana K Malone; Arnon Nagler; Seema Naik; Taiga Nishihori; Susan K Parsons; Angela Scherwath; Hannah-Lise Schofield; Robert Soiffer; Jeff Szer; Ida Twist; Anne B Warwick; Baldeep M Wirk; Jean Yi; Minoo Battiwalla; Mary D E Flowers; Bipin Savani; Bronwen E Shaw Journal: Bone Marrow Transplant Date: 2018-01-17 Impact factor: 5.483
Authors: Zev M Nakamura; Allison M Deal; Donald L Rosenstein; Laura J Quillen; Stephanie A Chien; William A Wood; Thomas C Shea; Eliza M Park Journal: Support Care Cancer Date: 2020-08-23 Impact factor: 3.603
Authors: Rebecca A Harrison; Noha Sharafeldin; Jennie L Rexer; Brennan Streck; Melissa Petersen; Ashley M Henneghan; Shelli R Kesler Journal: Oncologist Date: 2021-07-12