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Cognitive functioning of older adults prior to hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 56, pages 2575–2581 (2021)Cite this article

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Abstract

Hematopoietic cell transplantation is increasingly used in older adults with hematological malignancies. Younger adult patients who undergo HCT have shown to commonly present with cognitive impairment and depression prior to transplant; however, little research has been done to understand the cognitive and emotional functioning of older adults undergoing HCT. This study aimed to investigate the rate of cognitive impairment in a retrospective sample of older adult HCT candidates prior to transplant using a comprehensive battery. Ninety-three patients over the age of 60 completed a neuropsychology test battery that assessed standard domains of cognitive and emotional functioning. Impairment was defined as z-scores = < −1.5 on at least two tests or a z score = < −2.0 on at least one test. Results indicated that over 68% of patients were impaired with nearly a third of the sample showing impairment in verbal learning and memory and approximately one fifth showing impairments in aspects of executive function, processing speed, and visual learning. Ten percent of the patients endorsed symptoms indicative of a clinical level of depression. Medical comorbidities nor depression predicted cognitive impairment. These findings suggest that older adults candidates for HCT are at risk for cognitive impairment prior to transplant and thus cognition should be a consideration when developing treatment plans.

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Fig. 1: Flow diagram of study sample.

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Authors and Affiliations

  1. University of Chicago Medical Center, Chicago, USA

    Maureen Lacy & Michael Bishop

  2. Washington University in St. Louis, St. Louis, MO, USA

    Mandy Fong

  3. Vanderbilt University, Nashville, TN, USA

    Corey Bolton

  4. University of California, Los Angeles, CA, USA

    Michael Maranzano

  5. City of Hope National Medicine Center, Duarte, CA, USA

    Andrew Artz

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  1. Maureen Lacy
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Correspondence to Maureen Lacy.

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Lacy, M., Fong, M., Bolton, C. et al. Cognitive functioning of older adults prior to hematopoietic stem cell transplantation. Bone Marrow Transplant 56, 2575–2581 (2021). https://doi.org/10.1038/s41409-021-01331-9

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