Cognitive Performance in Patients With Multiple Myeloma Treated With an Autologous Stem Cell Transplant: Results of...

Patients with newly diagnosed multiple myeloma undergo induction chemotherapy, followed by high-dose chemotherapy and autologous hematopoietic cell transplant (auto-HCT). The impact of auto-HCT on cognitive function is not well understood. We evaluated longitudinal changes in cognitive function after auto-HCT in patients with multiple myeloma.

Patients with newly diagnosed multiple myeloma who completed induction chemotherapy and underwent pre-transplant evaluation were enrolled prospectively. Patients completed the self-administered gerocognitive exam (SAGE) and specialist-administered Montreal cognitive assessment (MoCA) at 3 time points: pre-transplant (baseline), 100-days post-transplant, and 1-year post-transplant. Scores were reported as means and standard deviations. Paired t-tests evaluated longitudinal differences.

Thirty-eight (100%) participants completed the MoCA and SAGE at baseline and 100-days post-transplant, and nineteen (50%) participants completed both at 1-year post-transplant. The mean total MoCA score was 25.00 (SD = 3.05) at baseline, 25.87 (SD = 2.68) at 100-days post-transplant, and 26.00 (SD = 2.81) at 1-year post-transplant. The mean total SAGE score was 17.00 (SD = 3.89) at baseline, 17.76 (SD = 3.07) at 100-days post-transplant, and 18.18 (SD = 3.23) at 1-year post-transplant. At 100-days post-transplant, the mean change from baseline in MoCA score was 0.87 (SD = 3.16; P = .10) and the mean change in SAGE score was 0.76 (SD = 2.62; P = .08). Participants did not indicate a preference for self-administered versus provider-administered measures.

Our study shows that auto-HCT was not associated with cognitive decline on objective assessment. Cognitive assessment is feasible and acceptable, with good correlation between self-administered tests and those administered by trained specialists.