TY - JOUR
T1 - Course of cognitive decline in hematopoietic stem cell transplantation: A within-subjects design
AU - Friedman, Melissa A.
AU - Fernandez, Mercedes
AU - Wefel, Jeffrey S.
AU - Myszka, Katherine A
AU - Champlin, Richard E.
AU - Meyers, Christina A.
PY - 2009/9/18
Y1 - 2009/9/18
N2 - This study examined the course of clinically significant cognitive change in hematopoietic stem cell transplant (HSCT), using a Reliable Change Index (RCI). Neuropsychological evaluations were administered to 117 patients before HSCT. Thirty-three received subsequent evaluations 6 and 28 weeks later. Of 117 patients, 39% were classified as impaired before HSCT. Of the 33 receiving subsequent evaluations, 47% showed reliable decline at 6-weeks; of these, 33% showed reliable decline again at 28-weeks. Mood and QOL did not account for declines. Verbal learning, psychomotor speed, and executive function showed greatest vulnerability to pre-HSCT impairment, and verbal learning showed greatest likelihood of further, subsequent decline. In conclusion, a subgroup of patients showed cognitive impairment before HSCT, indicating that factors other than HSCT contributed to cognitive deficits. Another subgroup showed further decline after HSCT. This study demonstrated the utility of the RCI in describing cognitive change in HSCT patients.
AB - This study examined the course of clinically significant cognitive change in hematopoietic stem cell transplant (HSCT), using a Reliable Change Index (RCI). Neuropsychological evaluations were administered to 117 patients before HSCT. Thirty-three received subsequent evaluations 6 and 28 weeks later. Of 117 patients, 39% were classified as impaired before HSCT. Of the 33 receiving subsequent evaluations, 47% showed reliable decline at 6-weeks; of these, 33% showed reliable decline again at 28-weeks. Mood and QOL did not account for declines. Verbal learning, psychomotor speed, and executive function showed greatest vulnerability to pre-HSCT impairment, and verbal learning showed greatest likelihood of further, subsequent decline. In conclusion, a subgroup of patients showed cognitive impairment before HSCT, indicating that factors other than HSCT contributed to cognitive deficits. Another subgroup showed further decline after HSCT. This study demonstrated the utility of the RCI in describing cognitive change in HSCT patients.
KW - cancer
KW - cognition
KW - hematologic malignancy
KW - neuropsychology
KW - neurotoxicity
KW - treatment effects
UR - https://nsuworks.nova.edu/cps_facarticles/1081
U2 - 10.1093/arclin/acp060
DO - 10.1093/arclin/acp060
M3 - Article
C2 - 19767298
SN - 0887-6177
VL - 24
JO - Archives of Clinical Neuropsychology
JF - Archives of Clinical Neuropsychology
ER -