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Impact of patient and clinical characteristics on cognitive changes after allogeneic hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 56, pages 3100–3103 (2021)Cite this article

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Objectively measured and patient-reported cognitive dysfunction have been increasingly recognized in patients who receive allogeneic hematopoietic stem cell transplantation (allo-HSCT) [1]. However, there is insufficient evidence regarding expected post-HSCT cognitive trajectories and limited understanding of which patients may be at risk for worse cognitive outcomes. The objectives of this study were to: (1) describe objectively measured cognitive function from prior to through 6 months after allo-HSCT and (2) explore patient and clinical variables that may affect cognitive trajectories.

This secondary data analysis examined objectively measured cognition among participants who enrolled in a randomized clinical trial of intravenous (IV) thiamine for delirium prevention (NCT03263442) [2]. Participants were admitted to the University of North Carolina (UNC) for allo-HSCT between October 2017 and February 2020, randomized to thiamine 200 mg IV TID for 7 days versus placebo, and monitored for delirium. Eligibility criteria were: at least 18 years of age, English speaking, not pregnant, and no previous adverse reaction to IV thiamine. Because none of the trial outcomes were different between study arms [2], all 66 trial participants were evaluated as a combined cohort in the current analysis. All participants provided written informed consent. The study was approved by the UNC Institutional Review Board and Lineberger Comprehensive Cancer Center Protocol Review Committee.

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Acknowledgements

This work was supported by the Rising Tide Foundation for Clinical Cancer Research (Grant Number CCR-17-300, Co-Principal Investigators ZMN and DLR), the National Institutes of Health (Grant Numbers 5K07CA218167-03, Principal Investigator EMP; and 5K12HD001441, Scholar ZMN), and the University of North Carolina Cancer Research Fund. The content is solely the responsibility of the authors and does not necessarily represent the official view of the NIH. The funders were not involved in the drafting of this manuscript. The authors gratefully acknowledge the UNC Bone Marrow Transplant providers, nurses, pharmacists, and staff. The authors also thank UNC Investigational Drug Services, UNC McLendon Laboratories, and Michelle Manning, MPH (University of North Carolina School of Medicine, Chapel Hill, NC) for her invaluable study management support.

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Authors and Affiliations

  1. Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Zev M. Nakamura, Eliza M. Park, Laura J. Quillen, Stephanie A. Chien, Bradley N. Gaynes & Donald L. Rosenstein

  2. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Zev M. Nakamura, Eliza M. Park, Allison M. Deal, Kate E. Stanton, William A. Wood, Thomas C. Shea & Donald L. Rosenstein

  3. Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Hillary M. Heiling & Bradley N. Gaynes

  4. Department of Medicine, Division of Hematology/Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Eliza M. Park, William A. Wood, Thomas C. Shea & Donald L. Rosenstein

  5. Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Tim A. Ahles

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  1. Zev M. Nakamura
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Contributions

Conception/design: ZMN, EMP, AMD, WAW, TCS, DLR. Provision of study material or patients: WAW, TCS. Collection and/or assembly of data: ZMN, EMP, AMD, LJQ, SAC, KES, DLR. Data analysis and interpretation: ZMN, HMH, AMD, WAW, BNG, TAA, TCS, DLR. Manuscript writing: ZMN, DLR. Final approval of manuscript: ZMN, HMH, EMP, AMD, LJQ, SAC, KES, WAW, BNG, TAA, TCS, DLR.

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Correspondence to Zev M. Nakamura.

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Competing interests

William A. Wood receives funding from Pfizer for research not directly related to this work. Otherwise, the authors have no conflicts of interest to disclose.

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Nakamura, Z.M., Heiling, H.M., Park, E.M. et al. Impact of patient and clinical characteristics on cognitive changes after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 56, 3100–3103 (2021). https://doi.org/10.1038/s41409-021-01481-w

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  • DOI: https://doi.org/10.1038/s41409-021-01481-w

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