Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-24T06:03:00.210Z Has data issue: false hasContentIssue false
  • English
  • Français

A mixed methods analysis of perceived cognitive impairment in hematopoietic stem cell transplant survivors

Published online by Cambridge University Press:  21 September 2018

Lisa M. Wu Open the ORCID record for Lisa M. Wu [Opens in a new window] ,
Nadia Kuprian ,
Krista Herbert ,
Ali Amidi ,
Jane Austin ,
Heiddis Valdimarsdottir  and
Christine Rini
Lisa M. Wu*
Affiliation:
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, United States
Nadia Kuprian
Affiliation:
Derner Institute of Advanced Psychological Studies, Adelphi University, Garden City, New York, United States
Krista Herbert
Affiliation:
Department of Psychology, Rowan University, Glassboro, New Jersey, United States
Ali Amidi
Affiliation:
Unit for Psychooncology and Health Psychology, Department of Psychology, Aarhus University, Aarhus, Denmark Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
Jane Austin
Affiliation:
Department of Psychology, William Paterson University, Wayne, New Jersey, United States
Heiddis Valdimarsdottir
Affiliation:
Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, United States Department of Psychology, Reykjavik University, Reykjavik, Iceland
Christine Rini
Affiliation:
John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, United States
*
Author for correspondence: Lisa M. Wu, Ph.D., Northwestern University Feinberg School of Medicine, 633 North St. Clair, 19th Floor, Chicago, IL 60611. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Hematopoietic stem cell transplant (HSCT) survivors may show evidence of objective cognitive impairment; however, perceived cognitive problems and their impact on quality of life are less well-understood. The purpose of this study was to explore HSCT survivors’ perceptions of cognitive impairment and its effect on daily life functioning.

Method

Sixty-nine autologous and allogeneic HSCT survivors nine months to three years posttransplant experiencing mild survivorship problems completed a brief structured interview regarding perceived cognitive impairment since transplant. Data were coded and content analyzed. The frequency of participants reporting cognitive problems by domain and associations between reports of cognitive problems and age, depressed mood, anxiety, and health-related quality of life were examined.

Result

Overall, 49 of the 69 participants (71%) reported cognitive impairments after transplant: 38 in memory (55%), 29 in attention and concentration (42%), and smaller numbers in other domains. There were no significant differences in problems reported by transplant type. Of the 50 participants who worked before transplant, 19 (38%) did not return to work following transplant, with 12 citing cognitive and health problems as being the reason. There were significant associations between reports of cognitive impairment and younger age (p = 0.02), depressed mood (p = 0.02), anxiety (p = 0.002), and health-related quality of life (p = 0.008).

Significance of results

A large proportion of survivors reported cognitive impairment following HSCT that impaired daily life functioning. Perceived cognitive impairment was associated with younger age, greater distress and reduced health-related quality of life.

Keywords

Cancer survivorscancer-related cognitive impairmentcognitive dysfunctionhematopoietic stem cell transplantationqualitative researchquality of life
Type
Original Article
Information
Palliative & Supportive Care , Volume 17 , Issue 4 , August 2019 , pp. 396 - 402
Copyright
Copyright © Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Amidi, A, Christensen, S, Mehlsen, M, et al. (2015) Long-term subjective cognitive functioning following adjuvant systemic treatment: 7–9 years follow-up of a nationwide cohort of women treated for primary breast cancer. British Journal of Cancer 113(5), 794–801.Google Scholar
Baddeley, A, Eysenck, MW, and Anderson, MC (2009) Memory (Vol. 1st). New York: Psychology Press.Google Scholar
Booth-Jones, M, Jacobsen, PB, Ransom, S, et al. (2005) Characteristics and correlates of cognitive functioning following bone marrow transplantation. Bone Marrow Transplantation 36(8), 695–702.Google Scholar
Bush, NE, Donaldson, GW, Haberman, MH, et al. (2000) Conditional and unconditional estimation of multidimensional quality of life after hematopoietic stem cell transplantation: A longitudinal follow-up of 415 patients. Biology of Blood and Marrow Transplantation 6(5A), 576–591.Google Scholar
Cella, DF, Tulsky, DS, Gray, G, et al. (1993) The Functional Assessment of Cancer Therapy scale: Development and validation of the general measure. Journal of Clinical Oncology 11(3), 570–579.Google Scholar
Cooke, L, Chung, C, and Grant, M (2011) Psychosocial care for adolescent and young adult hematopoietic cell transplant patients. Journal of Psychosocial Oncology 29(4), 394–414.Google Scholar
Copelan, EA (2006) Hematopoietic stem-cell transplantation. The New England Journal of Medicine 354(17), 1813–1826.Google Scholar
Çuhadar, D, Tanriverdi, D, Pehlivan, M, et al. (2016) Determination of the psychiatric symptoms and psychological resilience levels of hematopoietic stem cell transplant patients and their relatives. European Journal of Cancer Care 25(1), 112–121.Google Scholar
Derogatis, LR (1993) BSI brief symptom inventory: Administration, scoring, and procedures manual, 4th vol. Minneapolis, MN: National Computer Systems.Google Scholar
Duijts, SFA, van der Beek, AJ, Boelhouwer, IG, et al. (2016) Cancer-related cognitive impairment and patients’ ability to work. Current Opinion in Supportive and Palliative Care 11(1), 19–23.Google Scholar
Friedman, MA, Fernandez, M, Wefel, JS, et al. (2009) Course of cognitive decline in hematopoietic stem cell transplantation: A within-subjects design. Archives of Clinical Neuropsychology 24(7), 689–698.Google Scholar
Ganz, PA, Bower, JE, Kwan, L, et al. (2013) Does tumor necrosis factor-alpha (TNF-alpha) play a role in post-chemotherapy cerebral dysfunction? Brain, Behavior, and Immunity 30(Suppl), S99–S108.Google Scholar
Gioia, GA and Isquith, PK (2004) Ecological Assessment of Executive Function in Traumatic Brain Injury. Developmental Neuropsychology 25(1–2), 135–158.Google Scholar
Harder, H, Cornelissen, JJ, Van Gool, AR, et al. (2002) Cognitive functioning and quality of life in long-term adult survivors of bone marrow transplantation. Cancer 95(1), 183–192.Google Scholar
Harder, H, Duivenvoorden, HJ, van Gool, AR, et al. (2006) Neurocognitive functions and quality of life in haematological patients receiving haematopoietic stem cell grafts: A one-year follow-up pilot study. Journal of Clinical and Experimental Neuropsychology 28(3), 283–293.Google Scholar
Hutchinson, AD, Hosking, JR, Kichenadasse, G, et al. (2012) Objective and subjective cognitive impairment following chemotherapy for cancer: A systematic review. Cancer Treatment Reviews 38(7), 926–934.Google Scholar
Jacobs, SR, Jacobsen, PB, Booth-Jones, M, et al. (2007) Evaluation of the functional assessment of cancer therapy cognitive scale with hematopoietic stem cell transplant patients. Journal of Pain and Symptom Management 33(1), 13–23.Google Scholar
Jim HS, L, Syrjala, KL, and Rizzo, D (2012) Supportive care of hematopoietic cell transplant patients. Biology of Blood and Marrow Transplantation: Journal of the American Society for Blood and Marrow Transplantation, 18(1 Suppl), S12–S16.Google Scholar
Johnson Vickberg, SM, Duhamel, KN, Smith, MY, et al. (2001) Global meaning and psychological adjustment among survivors of bone marrow transplant. Psycho-Oncology 10(1), 29–39.Google Scholar
Kelly, DL, Buchbinder, D, Duarte, RF, et al. (2018) Neurocognitive dysfunction in hematopoietic cell transplant recipients: Expert review from the Late Effects and Quality of Life Working Committee of the Center for International Blood and Marrow Transplant Research and Complications and Quality of Life Working Party of the European Society for Blood and Marrow Transplantation. Biology of Blood and Marrow Transplantation 24(2), 228–241.Google Scholar
Khera, N, Chang, Y, Hashmi, S, et al. (2014). Financial burden in recipients of allogeneic hematopoietic cell transplantation. Biology of Blood and Marrow Transplantation 20(9), 1375–1381.Google Scholar
Lezak, MD, Howieson, DB, Bigler, ED, et al. (2012). Neuropsychological assessment. New York: Oxford University Press.Google Scholar
McQuellon, RP, Russell, GB, Cella, DF, et al. (1997) Quality of life measurement in bone marrow transplantation: development of the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) scale. Bone Marrow Transplantation 19(4), 357–368.Google Scholar
Mirsky, AF, Anthony, BJ, Duncan, CC, Ahearn, MB, and Kellam, SG (1991) Analysis of the elements of attention: a neuropsychological approach. Neuropsychology Review 2(2), 109–145.Google Scholar
Mitchell, KSJ, Delfont, S, Bracey, ML, et al. (2018) Top ten concerns burdening people with cancer: Perceptions of patients with cancer and the nurses caring for them. European Journal of Oncology Nursing 33, 102–106.Google Scholar
Mosher, CE, Redd, WH, Rini, CM, et al. (2009) Physical, psychological, and social sequelae following hematopoietic stem cell transplantation: A review of the literature. Psycho-Oncology 18(2), 113–127.Google Scholar
Murman, DL (2015) The impact of age on cognition. Seminars in Hearing 36(3), 111–21.Google Scholar
Ollendick, TH and Schroeder, CS (2003) Encyclopedia of clinical child and pediatric psychology. New York: Kluwer Academic/Plenum Publishers.Google Scholar
Patton, MQ (2002) Qualitative research and evaluation methods, 3rd ed. Thousand Oaks, CA: Sage Publications, Inc.Google Scholar
Poppelreuter, M, Weis, J, Mumm, A, et al. (2008) Rehabilitation of therapy-related cognitive deficits in patients after hematopoietic stem cell transplantation. Bone Marrow Transplantation 41(1), 79–90.Google Scholar
Reisberg, B, Shulman, MB, Torossian, C, et al. (2010) Outcome over seven years of healthy adults with and without subjective cognitive impairment. Alzheimer's & Dementia 6(1), 11–24.Google Scholar
Richards, JM and Gross, JJ (2000) Emotion regulation and memory: The cognitive costs of keeping one's cool. Journal of Personality and Social Psychology 79(3), 410–424.Google Scholar
Rini, C, Austin, J, Wu, LM, et al. (2014) Harnessing benefits of helping others: A randomized controlled trial testing expressive helping to address survivorship problems after hematopoietic stem cell transplant. Health Psychology 33(12), 1541–1551.Google Scholar
Rosen, WG (1980) Verbal fluency in aging and dementia. Journal of Clinical Neuropsychology 2(2), 135–146.Google Scholar
Scherwath, A, Schirmer, L, Kruse, M, et al. (2013) Cognitive functioning in allogeneic hematopoietic stem cell transplantation recipients and its medical correlates: A prospective multicenter study. Psycho-Oncology 22(7), 1509–1516.Google Scholar
Shao, Z, Janse, E, Visser, K and Meyer, AS (2014) What do verbal fluency tasks measure? Predictors of verbal fluency performance in older adults. Frontiers in Psychology 5, 772.Google Scholar
Sherman, RS, Cooke, E, and Grant, M (2005) Dialogue among survivors of hematopoietic cell transplantation. Journal of Psychosocial Oncology 23(1), 1–24.Google Scholar
Syrjala, KL, Artherholt, SB, Kurland, BF, et al. (2011) Prospective neurocognitive function over 5 years after allogeneic hematopoietic cell transplantation for cancer survivors compared with matched controls at 5 years. Journal of Clinical Oncology 29(17), 2397–2404.Google Scholar
Syrjala, KL, Dikmen, S, Langer, SL, et al. (2004) Neuropsychologic changes from before transplantation to 1 year in patients receiving myeloablative allogeneic hematopoietic cell transplant. Blood 104(10), 3386–3392.Google Scholar
Syrjala, KL, Langer, SL, Abrams, JR, et al. (2004) Recovery and long-term function after hematopoietic cell transplantation for leukemia or lymphoma. Journal of the American Medical Association 291(19), 2335–2343.Google Scholar
Wu, LM, Austin, J, Hamilton, JG, et al. (2012) Self-efficacy beliefs mediate the relationship between subjective cognitive functioning and physical and mental well-being after hematopoietic stem cell transplant. Psycho-Oncology 21(11), 1175–1184.Google Scholar
Zeng, Y, Cheng, ASK, Song, T, et al. (2017) Subjective cognitive impairment and brain structural networks in Chinese gynaecological cancer survivors compared with age-matched controls: A cross-sectional study. BMC Cancer 17(1), 796.Google Scholar