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Neurocognitive functioning in long-term survivors of pediatric hematopoietic cell transplantation
Kendra R Parris1, Kathryn M Russell2, Brandon M Triplett3
1Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA. kendra.parris@stjude.org.
Insights
Long-term survivors of pediatric hematopoietic cell transplantation (HCT) generally show intact neurocognitive function, but some experience deficits. Graft-vs-host disease can impact processing speed and verbal learning in HCT survivors.
Area of Science:
- Neuroscience
- Pediatric Oncology
- Hematology
Background:
- Pediatric hematopoietic cell transplantation (HCT) survivors face risks of cognitive and academic impairment.
- Long-term neurocognitive effects (>5 years post-HCT) are less understood than early effects.
Purpose of the Study:
- To assess global and specific neurocognitive functioning in long-term pediatric HCT survivors.
- To compare survivor performance against normative data and healthy peers.
- To investigate the influence of medical and demographic factors on neurocognitive outcomes.
Main Methods:
- A comprehensive neurocognitive test battery was administered to 83 long-term HCT survivors and 50 healthy controls.
- Statistical analyses compared survivor performance to normative data and the control group.
- The impact of variables like graft-vs-host disease and total body irradiation was examined.
Main Results:
- Most survivors performed within the average range but were significantly lower than test norms and controls on several measures.
- Graft-vs-host disease was associated with slower processing speed and reduced verbal learning.
- Total body irradiation did not correlate with any neurocognitive performance measure.
Conclusions:
- Long-term neurocognitive impact is relatively small for most pediatric HCT survivors.
- Specific subgroups, particularly those with graft-vs-host disease, are at higher risk for neurocognitive impairment.
- Further research is needed to understand and mitigate long-term cognitive sequelae.
Abstract:
Survivors of pediatric hematopoietic cell transplantation (HCT) are at risk for impairment in cognitive and academic function. Most research to date has focused on the first years following transplant, and less is known about the long-term effects. We examined global and specific neurocognitive functioning in long-term (>5 years post HCT) survivors in comparison to both normative data and a sample of demographically similar healthy peers. A comprehensive battery of neurocognitive measures was obtained from 83 long-term survivors and 50 healthy comparisons. Analyses were conducted to assess for differences in neurocognitive functions between survivors, normative means, and healthy comparisons, and to examine the impact of medical and demographic variables on neurocognitive performance. Survivors' performance was within the Average range across most measures, although significantly lower than both test norms and healthy comparisons on several measures. Despite generally intact neurocognitive functioning in the survivor group as a whole, survivors who experienced graft-vs.-host disease demonstrated slower processing speed and weaker verbal learning. Use of total body irradiation was not associated with any performance-based measure of neurocognitive functioning. Although subgroups of patients may be at relatively higher risk of neurocognitive impairment, the long-term neurocognitive impact for most survivors is relatively small.
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