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Neuropsychological outcome of children undergoing bone marrow transplantation
1Division of Oncology, The Children's Hospital of Philadelphia, PA 19104-4399, USA.
Insights
Bone marrow transplants (BMT) in children did not significantly impact neuropsychological functioning one year post-procedure. Both chemotherapy and chemotherapy with total body irradiation showed no detrimental effects on cognitive abilities.
Area of Science:
- Pediatric Oncology
- Neuropsychology
- Hematology
Background:
- Bone marrow transplantation (BMT) is a critical treatment for various pediatric disorders.
- Neuropsychological deficits can be a concern following BMT due to treatment modalities like chemotherapy and total body irradiation (TBI).
- Long-term cognitive outcomes in pediatric BMT survivors require thorough investigation.
Purpose of the Study:
- To prospectively assess the neuropsychological functioning of children and adolescents undergoing BMT.
- To compare cognitive outcomes between patients receiving chemotherapy only versus chemotherapy plus TBI.
- To identify potential factors influencing neuropsychological status one year after BMT.
Main Methods:
- A prospective study involving 122 children and adolescents undergoing BMT for malignant or nonmalignant conditions.
- Neuropsychological evaluations were conducted pre-BMT and one year post-BMT for surviving patients.
- Patients were categorized into 'chemotherapy only' (chemo) and 'chemotherapy + total body irradiation' (chemo + TBI) groups for analysis using t-tests and regression analysis.
Main Results:
- No statistically significant differences were observed in global or specific neuropsychological functioning at one year post-BMT.
- Regression analysis did not reveal significant effects of treatment type (chemo vs. chemo + TBI), age, or gender on neuropsychological outcomes.
- The findings indicate that neither chemotherapy nor chemotherapy combined with TBI had a detrimental impact on cognitive function one year after BMT.
Conclusions:
- Neuropsychological functioning in children and adolescents appears resilient one year after bone marrow transplantation.
- Current BMT protocols involving chemotherapy and/or TBI do not seem to cause significant long-term cognitive impairment in this pediatric population.
- Further research may explore later time points and specific cognitive domains to fully understand the long-term effects of BMT.
Abstract:
The purpose of the study was to prospectively evaluate the neuropsychological functioning of children and adolescents receiving a bone marrow transplant (BMT). One hundred and twenty-two children with malignant or nonmalignant disorders and no previous cranial radiation therapy received a pre-BMT neuropsychological evaluation. Surviving children received a 1 year post-BMT neuropsychological evaluation. Patients were placed in a chemotherapy only (chemo) or a chemotherapy and total body irradiation (chemo + TBI) group for statistical analysis. The data were analyzed by t-tests for paired samples. There were no statistically significant differences. Regression analysis failed to identify treatment, age and gender effects. The results suggest that global and specific areas of neuropsychological functioning 1 year post-BMT were not detrimentally affected by chemotherapy or chemotherapy with total body irradiation.
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