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Long-term neuropsychological risks in pediatric bone marrow transplant: what do we know?
1Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City 52242, USA.
Insights
Bone marrow transplant (BMT) and prior cranial radiation therapy (CRT) can negatively impact children's IQ, memory, and motor skills. Younger age at diagnosis and prior CRT increase risks for these neurocognitive deficits.
Area of Science:
- Pediatric Oncology
- Neuropsychology
- Hematopoietic Stem Cell Transplantation
Background:
- Established research links cranial radiation and chemotherapy to neuropsychological deficits in childhood cancer survivors.
- The specific impact of the bone marrow transplant (BMT) process itself on pediatric neurocognitive outcomes remains largely uncharacterized.
Purpose of the Study:
- To investigate the longitudinal neuropsychological effects of the BMT process in pediatric cancer patients.
- To identify potential risk factors associated with neurocognitive decline following BMT.
Main Methods:
- Longitudinal assessment of neuropsychological functioning in children undergoing BMT.
- Evaluation included measures of IQ, academic achievement, memory, and fine motor skills.
- Pre-BMT and 4-year post-BMT data collection.
Main Results:
- Children with prior cranial radiation therapy (CRT) exhibited declining IQ scores and below-average academic achievement even before BMT.
- Four years post-BMT, significant declines were observed in IQ, academic achievement, memory, and fine motor skills.
- Younger age at diagnosis and prior CRT emerged as potential risk factors for neurocognitive impairment.
Conclusions:
- The BMT process, particularly in conjunction with prior CRT, poses significant risks to the neurocognitive functioning of pediatric cancer patients.
- Early identification of risk factors like younger age and prior radiation is crucial for targeted interventions.
- Further research is warranted to fully elucidate the complex interplay of treatments and long-term neurocognitive outcomes.
Abstract:
While research has documented neuropsychological sequelae following cranial radiation and chemotherapy for childhood cancer, little is known about the effects of the BMT process on the neuropsychological functioning of children. Results from ongoing studies at The University of Iowa indicate that at pre-BMT evaluations, children who have had prior CRT already show signs of declining IQ scores and below average academic achievement. By 4 years post-BMT, there is evidence of declining IQ, achievement, memory, and fine motor skills. Risk factors appear to be younger age at diagnosis and CRT prior to BMT but additional research is needed.