Mental status changes after hematopoietic stem cell transplantation
Chang G et al. - In a study to evaluate and compare neurocognitive changes in pts with chronic myelogenous leukemia (CML) or primary myelodysplastic syndrome (MDS) after allogeneic hematopoietic stem cell transplantation (HSCT) or other therapies, it was concluded that time and diagnosis may be important factors when assessing neurocognitive and other changes. Complaints regarding chemobrain after HSCT merit further study, because deficits may predate initiation of treatment and subsequently may improve. The results could reassure prospective HSCT recipients, because HSCT compared favorably with other treatments when mental status side effects were considered. Methods- Serial evaluations of attention, concentration, memory, mood, and quality of life were used in a consecutive sample of 106 eligible pts who had CML (n=91) or MDS (n=15) at enrollment and then 12 mos and 18 mos after HSCT or other therapy.
Results- The 3 evaluations at enrollment, 12 mos, and 18 mos were completed by 98%, 95%, and 89% of surviving participants, respectively.
- Among all pts, there was significant improvement in memory over 18 mos.
- The 45 pts who underwent HSCT (42 pts with CML and 3 with MDS) compared favorably with pts who received other treatment on most measures of neuropsychological function, except they had improved mental health, worse physical function, and more difficulty with coordination and fine motor speed bilaterally.
- Pts with CML overall had improved phonemic fluency.
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