Blood or Marrow Transplantation Recipients Experience Higher Risks of Cognitive Impairment

During the posttransplantation years, allogeneic blood or marrow transplantation (BMT) recipients have a higher risk of cognitive impairment, according to a study published in the Journal of Clinical Oncology.

This study is the first to measure the impacts myeloablative allogenic BMT can have on a patient’s cognitive functioning, affecting a survivor’s ability to integrate with a group of people and return to work. In addition, BMT recipients can experience a weakened memory, a loss of attention and concentration, and difficulty learning.

“With this research from our longitudinal prospective assessment, we are able to deduce that a significant population of allogeneic BMT survivors will experience cognitive impairment that can and will impact different aspects of their lives moving forward,” Noha Sharafeldin, MD, MSc, PhD, instructor in University of Alabama at Birmingham’s Institute for Cancer Outcomes and Survivorship and Division of Hematology and Oncology, said in a statement. “And it’s critical that we as clinicians develop interventions for these patients. This research is the just beginning of our figuring out how we can best care for BMT survivors and enable them to live healthy lives.”

The 477 patients treated with a BMT at City of Hope completed standardized neuropsychological testing before their transplant, and then at the 6-month and 1-, 2-, and 3-year anniversaries of the procedure. Patients were tested on executive function, verbal fluency and speed, processing speed, working memory, visual and auditory memory, and fine motor dexterity. As a control group, 99 healthy patients completed the same cognitive benchmark as a comparison for BMT patients.

After 3 years, posttransplant cognitive impairment was present in 35.7% of allogeneic recipients. In addition, 38% of the participants had yet to return to work, while mental impairment caused a 10-fold increased chances of not returning to work 3 years after the transplant.

“From this data, it’s clear that we have to make strides in supporting allogeneic BMT recipients in their recovery to ensure that we are educating patients and their families on signs of cognitive impairment. This data will help us identify patients at highest risk of cognitive impairment and inform the development of interventions that facilitate a patient’s recovery and return to normal life,” Sharafeldin concluded.

References

Sharafeldin N, Bosworth A, Patel SK, et al. Cognitive functioning after hematopoietic cell transplantation for hematologic malignancy: results from a prospective longitudinal study. J Clin Oncol. 2018;36(5):463-475. doi: 10.1200/JCO.2017.74.2270.