Progressive declines in neurocognitive function among survivors of hematopoietic stem cell transplantation for pediatric hematologic malignancies.

Full Abstract

Neurocognitive function of pediatric patients is of great concern after hematopoietic stem cell transplantation (HSCT). We evaluated the neurocognitive function of pediatric patients pre-HSCT, 1, 3, and 5 years post-HSCT. All patients had a hematologic malignancy and received therapy to their central nervous system. Healthy siblings were tested as a comparison group. Pediatric patients with a hematologic malignancy did not have a significant decrease in their cognitive function before HSCT compared with their siblings except in areas of academic achievement. Our study population had significant declines in visual motor skills and memory test scores within the first year post-HSCT. By 3 years post-HSCT, there was an improvement in the visual motor development scores and memory scores, but there were new deficits in verbal skills. By 5 years post-HSCT, there were progressive declines in verbal skills (P=0.005), performance skills (0.04), and new deficits seen in long-term verbal memory scores (0.04). On the basis of the raw scores, most of these tests showed that patients had an inability to acquire new skills at a rate comparable to their age-matched healthy peers. However, long-term memory scores showed definite declines. The greatest decline in neurocognitive function occurred in those patients who received cranial irradiation either as part of their initial therapy or as part of their HSCT conditioning. Pediatric patients who received HSCT for hematologic malignancies have neurocognitive deficiencies that are both acute and chronic. Although some patients have acute deficits that appear and improve over time, other patients have progressive declines in neurocognitive function that are chronic.

Author information

Author/s: Shah, Ami J (AJ); Epport, Karen (K); Azen, Colleen (C); Killen, Renna (R); Wilson, Kathy (K); De Clerck, Dominique (D); Crooks, Gay (G); Kapoor, Neena (N); Kohn, Donald B (DB); Parkman, Robertson (R); Weinberg, Kenneth I (KI);

Affiliation: Department of Pediatrics, Division of Research Immunology/Bone Marrow Transplantation, Childrens Hospital, Los Angeles, CA 90027, USA. Ashah(-atsign-)chla.usc.edu

Grants: M01 RR00043 (Agency:NCRR NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural

Journal: Journal of pediatric hematology/oncology : official journal of the American Society of Pediatric Hematology/Oncology (J Pediatr Hematol Oncol), published in United States. (Language: eng)

Reference: 2008-Jun; vol 30 (issue 6) : pp 411-8

Dates: Created 2008/06/23; Completed 2008/07/22;

PMID: 18525456, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

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