Clinical predictors of cognitive function in adults treated with hematopoietic cell transplantation

Abstract

BACKGROUND: Studies suggest that patients with cancer who undergo hematopoietic cell transplantation (HCT) are at risk for cognitive deficits. To date, little research has investigated the cumulative effects of clinical risk factors on cognitive function in patients who undergo HCT. METHODS: Patients (N = 278) who were scheduled to undergo HCT for hematologic disease completed neuropsychological assessments before HCT and at 6 months and 12 months after HCT. A time-varying cumulative clinical risk variable was examined as a predictor of total neuropsychological performance (TNP). Cumulative clinical risk was calculated from pre-HCT neuropsychological risk factors (eg, history of cranial irradiation, intrathecal chemotherapy), HCT-related risk factors (eg, allogeneic transplantation, unrelated donor), and post-HCT complications (eg, severity of mucositis and enteritis, graft-versus-host disease). RESULTS: Patients with greater cumulative clinical risk displayed worse TNP at baseline and at 6 months after HCT and less neuropsychological recovery over time than patients who had less risk (Ps