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Neuropsychological and psychiatric functioning pre- and posthematopoietic stem cell transplantation in adult cancer patients: A preliminary study

Published online by Cambridge University Press:  13 December 2006

LEIGH J. BEGLINGER
Affiliation:
Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
KEVIN DUFF
Affiliation:
Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
SARA VAN DER HEIDEN
Affiliation:
Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
DAVID J. MOSER
Affiliation:
Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
JOHN D. BAYLESS
Affiliation:
Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
JANE S. PAULSEN
Affiliation:
Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
ROGER GINGRICH
Affiliation:
Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa

Abstract

The current study characterizes cognitive and psychiatric status in hematopoietic stem cell transplantation (HSCT) patients shortly before and after transplant. Thirty adult patients were assessed prospectively 1–2 weeks before transplantation and 100 days posttransplantation on neuropsychological and psychiatric measures. Before transplant, participants showed mild impairments on several neuropsychological measures, with the poorest performances occurring on learning and attention. Psychiatric functioning was significantly elevated compared with normative data. Significant improvements, however, were observed on neuropsychological measures by 100 days after transplant. Depression and anxiety scores also improved. Candidates for HSCT experienced mild diffuse cognitive dysfunction and psychiatric morbidity before the procedure, but these symptoms significantly improved by 3 months following their transplant in this small sample. Education about these possible pretransplant sequelae and the potential for rebound may be helpful to patients and families as they prepare for this treatment and the recovery period (JINS, 2007, 13, 172–177.)

Type
BRIEF COMMUNICATIONS
Copyright
© 2007 The International Neuropsychological Society

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References

REFERENCES

Ahles, T.A., Tope, D.M., Furstenberg, C., Hann, D., & Mills, L. (1996). Psychologic and neuropsychologic impact of autologous bone marrow transplantation. Journal of Clinical Oncology, 14, 14571462.CrossRefGoogle Scholar
Andrykowski, M.A., Altmaier, E.M., Barnett, R.L., Burish, T.G., Gingrich, R., & Henslee-Downey, P.J. (1990). Cognitive dysfunction in adult survivors of allogeneic marrow transplantation: Relationship to dose of total body irradiation. Bone Marrow Transplantation, 6, 269276.Google Scholar
Andrykowski, M.A., Schmitt, F.A., Gregg, M.E., Brady, M.J., Lamb, D.G., & Henslee-Downey, P.J. (1992). Neuropsychologic impairment in adult bone marrow transplant candidates. Cancer, 70, 22882297.3.0.CO;2-M>CrossRefGoogle Scholar
Booth-Jones, M., Jacobsen, P.B., Ransom, S., & Soety, E. (2005). Characteristics and correlates of cognitive functioning following bone marrow transplantation. Bone Marrow Transplantation, 36, 695702.CrossRefGoogle Scholar
Breitbart, W., Rosenfeld, B., Roth, A., Smith, M.J., Cohen, K., & Passik, S. (1997). The Memorial Delirium Assessment Scale. Journal of Pain and Symptom Management, 13, 128137.CrossRefGoogle Scholar
Derogatis, L.R., Lipman, R.S., Rickels, K., Uhlenhuth, E.H., & Covi, L. (1974). The Hopkins Symptom Checklist (HSCL): A self-report symptom inventory. Behavioral Science, 19, 115.CrossRefGoogle Scholar
Duff, K., Beglinger, L.J., Schoenberg, M.R., Patton, D.E., Mold, J., Scott, J.G., & Adams, R.L. (2005). Test-retest stability and practice effects of the RBANS in a community dwelling elderly sample. Journal of Clinical and Experimental Neuropsychology, 27, 565575.CrossRefGoogle Scholar
Fann, J.R., Roth-Roemer, S., Burington, B.E., Katon, W.J., & Syrjala, K.L. (2002). Delirium in patients undergoing hematopoietic stem cell transplantation. Cancer, 95, 19711981.CrossRefGoogle Scholar
Goldman, J.M. & Horowitz, M.M. (2002). The international bone marrow transplant registry. International Journal of Hematology, 76(Suppl. 1), 393397.CrossRefGoogle Scholar
Harder, H., Cornelissen, J.J., Van Gool, A.R., Duivenvoorden, H.J., Eijkenboom, W.M., & van den Bent, M.J. (2002). Cognitive functioning and quality of life in long-term adult survivors of bone marrow transplantation. Cancer, 95, 183192.CrossRefGoogle Scholar
Harder, H., Van Gool, A.R., Cornelissen, J.J., Duivenvoorden, H.J., Eijkenboom, W.M., Barge, R.M., & van den Bent, M.J. (2005). Assessment of pre-treatment cognitive performance in adult bone marrow or haematopoietic stem cell transplantation patients: A comparative study. European Journal of Cancer, 41, 10071016.CrossRefGoogle Scholar
Meyers, C.A., Weitzner, M., Byrne, K., Valentine, A., Champlin, R.E., & Przepiorka, D. (1994). Evaluation of the neurobehavioral functioning of patients before, during, and after bone marrow transplantation. Journal of Clinical Oncology, 12, 820826.CrossRefGoogle Scholar
Newman, M.F., Kirchner, J.L., Phillips-Bute, B., Gaver, V., Grocott, H., Jones, R.H., Mark, D.B., Reves, J.G., & Blumenthal, J.A. (2001). Longitudinal assessment of neurocognitive function after coronary-artery bypass surgery. New England Journal of Medicine, 344, 395402.CrossRefGoogle Scholar
Parth, P., Dunlap, W.P., Kennedy, R.S., Ordy, J.M., & Lane, N.E. (1989). Motor and cognitive testing of bone marrow transplant patients after chemoradiotherapy. Perceptual and Motor Skills, 68(Pt. 2), 12271241.Google Scholar
Peper, M., Steinvorth, S., Schraube, P., Fruehauf, S., Haas, R., Kimmig, B.N., Lohr, F., Wenz, F., & Wannenmacher, M. (2000). Neurobehavioral toxicity of total body irradiation: A follow-up in long-term survivors. International Journal of Radiation Oncology, Biology, Physics, 46, 303311.CrossRefGoogle Scholar
Psychological Corporation. (1999). Wechsler Abbreviated Scale of Intelligence (WASI) manual. San Antonio, TX: Psychological Corporation.
Randolph, C., Tierney, M.C., Mohr, E., & Chase, T.N. (1998). The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): Preliminary clinical validity. Journal of Clinical and Experimental Neuropsychology, 20, 310319.CrossRefGoogle Scholar
Reitan, R.M. (1955). The relation of the Trail Making Test to organic brain damage. Journal of Consulting Psychology, 19, 393394.CrossRefGoogle Scholar
Sostak, P., Padovan, C.S., Yousry, T.A., Ledderose, G., Kolb, H.J., & Straube, A. (2003). Prospective evaluation of neurological complications after allogeneic bone marrow transplantation. Neurology, 60, 842848.CrossRefGoogle Scholar
Syrjala, K.L., Dikmen, S., Langer, S.L., Roth-Roemer, S., & Abrams, J.R. (2004). Neuropsychologic changes from before transplantation to 1 year in patients receiving myeloablative allogeneic hematopoietic cell transplant. Blood, 104, 33863392.CrossRefGoogle Scholar
Teng, E.L. & Chui, H.C. (1987). The Modified Mini-Mental State (3MS) examination. Journal of Clinical Psychiatry, 48, 314318.Google Scholar
Trzepacz, P.T., Baker, R.W., & Greenhouse, J. (1988). A symptom rating scale for delirium. Psychiatry Research, 23, 8997.CrossRefGoogle Scholar
Wenz, F., Steinvorth, S., Lohr, F., Fruehauf, S., Wildermuth, S., van Kampen, M., & Wannenmacher, M. (2000). Prospective evaluation of delayed central nervous system (CNS) toxicity of hyperfractionated total body irradiation (TBI). International Journal of Radiation Oncology, Biology, Physics, 48, 14971501.CrossRefGoogle Scholar