Chemotherapy-related cognitive dysfunction and effects on quality of life in gynecologic cancer patients

Pearre, Diana C.; Bota, Daniela

doi:10.1080/23809000.2018.1443811

Cited by 17 publications

(10 citation statements)

References 60 publications

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“…However, some models based on clinical and animal experiments help us to speculate on the possible mechanisms. First, peripheral cytokines initiate the development of the chemobrain [22][23][24]. This cytokinemediated signaling cascade induces persistent epigenetic alterations.…”

Section: Discussionmentioning

confidence: 99%

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Toxic leukoencephalopathy with axonal spheroids caused by chemotherapeutic drugs other than methotrexate

Lim

Kim

et al. 2022

BMC Neurol

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Background The objective of this report is to share the clinicopathological features of chemotherapy-induced toxic leukoencephalopathy, which is a rare and under-recognized disease, clinically characterized by rapidly progressive cognitive loss that often leads to sudden death. Case presentation A 64-year-old woman and a 63-year-old man, who had both suffered from a rapid deterioration of consciousness, were autopsied under the clinical impressions of either the central nervous system graft versus host disease (CNS-GVHD), infectious encephalitis, or autoimmune encephalitis. Both patients had been treated with multiple chemotherapy regimens, including adriamycin, cytarabine arabinoside, daunorubicin, fludarabine, azacitidine, and allogeneic peripheral blood stem cell transplantation to treat hematological malignancies (acute myelogenous leukemia and myelodysplastic syndrome). Neuropathological findings at autopsy revealed rarefaction and vacuolar changes of the white matter with axonal spheroids, reactive gliosis, and foamy macrophage infiltration, predominantly in the visual pathways of the occipital and temporal lobes. Damaged axons exhibited immunoreactivity to beta-amyloid, consistent with axonopathy. However, there was no lymphocyte infiltration that suggested CNS-GVHD or any type of encephalitis. Conclusion The neuropathology found in the presented cases had the characteristic features of toxic leukoencephalopathy (chemobrain). Our cases showed that toxic leukoencephalopathy can also be caused by chemotherapy drugs other than methotrexate.

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Section: Discussionmentioning

confidence: 99%

“…These epigenetic changes alter gene expression, metabolic activity, and neuronal transmission that ultimately affect cognitive function. Chemotherapy drugs cause cellular stress and injury [22][23][24]. Axonal spheroids and axonal beta-amyloid deposits suggested axonal injury because beta-amyloid is a known marker for axonal injury [25].…”

Section: Discussionmentioning

confidence: 99%

Toxic leukoencephalopathy with axonal spheroids caused by chemotherapeutic drugs other than methotrexate

Lim

Kim

et al. 2022

BMC Neurol

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show abstract

“…However, some models based on clinical and animal experiments help us speculate the possible mechanism of chemo brain. Peripheral cytokines initiate the development of chemo brain [15][16][17]. This cytokine-mediated signaling cascade induces persistent epigenetic alterations.…”

Section: Discussionmentioning

confidence: 99%

“…These epigenetic changes alter gene expression, metabolic activity, and neuronal transmission that ultimately affect cognitive function. Chemotherapy drugs cause cellular stress and injury [15][16][17]. This induces an in ammatory response in the periphery, releasing cytokines such as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-8, IL-10, and monocyte chemoattractant protein-1 (MCP-1).…”

Section: Discussionmentioning

confidence: 99%

Toxic leukoencephalopathy caused by chemotherapeutic drugs other than methotrexate

Park¹,

Lim²,

Kim³

et al. 2021

Preprint

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Background & Objective Chemotherapy-induced toxic leukoencephalopathy is clinically characterized by progressive cognitive loss, often resulting in sudden death. The objective of this study is to share distinctive clinicopathological features of chemotherapy-induced brain change.Methods The brains of a 64-year-old woman and a 63-year-old man who suffered from rapid deterioration of consciousness were autopsied. The initial clinical impressions were central nervous system (CNS) graft versus host disease (GVHD), infectious or autoimmune encephalitis. Both patients had been treated with multidrug chemotherapy, including cytarabine arabinoside, daunorubicin, fludarabine, azacitidine, and busulfan, and allogeneic peripheral blood stem cell transplantation because of hematological malignancy (acute myelogenous leukemia and myelodysplastic syndrome). Results The autopsies revealed a vacuolar change of the white matter with axonal spheroids, reactive gliosis, and foamy macrophage infiltration in the brain, predominantly in the visual pathway of the occipital and temporal lobes. There was no lymphocytic infiltration in the brain tissue, which is characteristic of CNS-GVHD or encephalitis, suggesting these syndromes were not the cause of brain illness. Conclusion The leukoencephalopathy found in our cases is often occur after methotrexate treatment, but our autopsy cases showed that it can also be caused by a regimen of chemotherapeutic drugs other than methotrexate.

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“…17 Moreover, in the studies included in this review, the major cancer type was breast cancer [30][31][32] and the main cancer-related treatment that participants received was chemotherapy. [28][29][30][31][32] However, according to previous evidence, the changes of cognitive function are also experienced by patients with other non-CNS cancer types including colorectal cancer, 41 gynecologic cancer, 42 and so forth. In addition, although some chemotherapy regimens are associated with neurotoxicity on cognitive function, 43,44 other cancer-related treatments can also lead to changes in cognitive function.…”

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confidence: 99%

The Effect of Walking Intervention on Cognitive Function Among Patients With Non–Central Nervous System Cancer

2022

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Cognitive function Systematic review Walking Background: Cognitive impairment is one of the most frequently reported symptoms in patients with non-central nervous system (non-CNS) cancer. Walking has positive effects on cognitive function. However, the effects of walking interventions on cognitive function outcomes in patients with non-CNS cancer are not well synthesized. Objective: The aim of this study was to explore the characteristics of walking intervention and its effects on cognitive function in patients with non-CNS cancer. Methods: Ten databases were searched to identify eligible randomized controlled trials from each database's inception to June 7, 2021. The Physiotherapy Evidence Database Scale was used to assess the quality of the included studies. Results: Five randomized controlled trials involving 242 adults with non-CNS cancer were included. Two studies involving immediate treadmill walking interventions with moderate intensity at 40% to 60% maximal heart rate reported significantly improved objective cognitive domains of processing speed and spatial working memory with small to moderate effect sizes for cancer survivors. One study delivering home-based, moderate-intensity walking intervention had borderline significantly positive effects on perceived cognitive functioning for patients with non-CNS cancer during chemotherapy. Conclusion: Walking intervention with moderate intensity is a beneficial approach to improve objective cognitive domains of processing speed and spatial working memory and perceived cognitive function. Implications for Practice: Nurses may provide moderate-intensity walking with 40% to 60% maximal

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Chemotherapy-related cognitive dysfunction and effects on quality of life in gynecologic cancer patients

Cited by 17 publications

References 60 publications

Toxic leukoencephalopathy with axonal spheroids caused by chemotherapeutic drugs other than methotrexate

Toxic leukoencephalopathy with axonal spheroids caused by chemotherapeutic drugs other than methotrexate

Toxic leukoencephalopathy caused by chemotherapeutic drugs other than methotrexate

The Effect of Walking Intervention on Cognitive Function Among Patients With Non–Central Nervous System Cancer

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