What is known and unknown about chemotherapy‐related cognitive impairment in patients with haematological malignancies and areas of needed research

Williams, AnnaLynn; Zent, Clive S.; Janelsins, Michelle Christine

doi:10.1111/bjh.14211

Cited by 63 publications

(40 citation statements)

References 69 publications

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“…To our knowledge, this longitudinal cohort study is the first designed to investigate cognitive compensatory processes of older, clinically fit patients with hematologic malignancies undergoing chemotherapy, through the cognitive performance and associated psychological factors in novel and non‐novel contexts. As expected in our hypothesis in the light of available studies about hematologic malignancies, healthy controls performed more optimally than patients in both contexts. The findings did not confirm our first hypothesis that patients would not improve their cognitive performance over time compared to healthy controls.…”

Section: Discussionsupporting

confidence: 86%

Cognitive compensatory processes of older, clinically fit patients with hematologic malignancies undergoing chemotherapy: A longitudinal cohort study

et al. 2017

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Objective: Despite the well-known negative impacts of cancer and anticancer therapies on cognitive performance, little is known about the cognitive compensatory processes of older patients with cancer. This study was designed to investigate the cognitive compensatory processes of older, clinically fit patients with hematologic malignancies undergoing chemotherapy. Methods:We assessed 89 consecutive patients (age ≥ 65 y) without severe cognitive impairment and 89 age-, sex-, and education level-matched healthy controls. Cognitive compensatory processes were investigated by (1) comparing cognitive performance of patients and healthy controls in novel (first exposure to cognitive tasks) and non-novel (second exposure to the same cognitive tasks) contexts, and (2) assessing psychological factors that may facilitate or inhibit cognitive performance, such as motivation, psychological distress, and perceived cognitive performance. We assessed cognitive performance with theTrail-Making, Digit Span and FCSR-IR tests, psychological distress with the Hospital Anxiety and Depression Scale, and perceived cognitive performance with the FACT-Cog questionnaire.Results: In novel and non-novel contexts, average cognitive performances of healthy controls were higher than those of patients and were associated with motivation. Cognitive performance of patients was not associated with investigated psychological factors in the novel context but was associated with motivation and psychological distress in the non-novel context. Conclusions:Older, clinically fit patients with hematologic malignancies undergoing chemotherapy demonstrated lower cognitive compensatory processes compared to healthy controls.Reducing distress and increasing motivation may improve cognitive compensatory processes of patients in non-novel contexts. resources and strategies to perform a task. Clinically, these processes could be reflected, for example, in a feeling of not being able to function as before, a need to increase mental effort for a well-known task, and difficulties to benefit from previous experience.Although currently impossible to study directly, cognitive compensatory processes can be assessed indirectly through neuroimaging or longitudinal studies comparing cognitive performance of patients and healthy controls. In longitudinal studies, these processes should be studied by assessing the cognitive performance of older cancer patients in novel and non-novel contexts and by assessing psychological factors that may facilitate or inhibit cognitive performance.Cognitive performance in novel versus non-novel contexts may require different levels of compensatory processes. In a novel context, optimal performance requires memory skills to memorize instructions, as well as executive skills (eg, planning, inhibition, and elaboration strategies) to achieve a goal and reduce interference caused by the novel context itself.In a non-novel context, optimal performance requires the ability to remember and use previously acquired information through spec...

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Section: Discussionsupporting

confidence: 86%

Cognitive compensatory processes of older, clinically fit patients with hematologic malignancies undergoing chemotherapy: A longitudinal cohort study

et al. 2017

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“…Cancer‐related cognitive impairment (CRCI) is a commonly reported adverse effect of various malignancies and their therapies among adult survivors (Wefel et al , ). CRCI is usually characterized by diminution of memory, attention, executive functioning and processing speed (Ahles & Saykin, ; Argyriou et al , ; Williams et al , ). The majority of CRCI studies were performed on breast cancer patients, while several small‐size studies incorporated patients with prostate, colorectal, or haematological cancers (Wefel et al , ).…”

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confidence: 99%

Cognitive impairment in hodgkin lymphoma survivors

Trachtenberg¹,

Mashiach

Hayun

et al. 2018

Br J Haematol

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Cancer-related cognitive impairment (CRCI) is commonly reported post-chemotherapy in adults with solid tumours. Hodgkin lymphoma (HL) mostly affects young adults. Data regarding CRCI in HL survivors (HLS) are scarce. The current study aimed to objectively assess CRCI incidence and characteristics in HLS. HLS, who completed first-line (chemotherapy ± radiation) therapy and remained in complete remission for 6 months to 5 years from therapy end, were evaluated. Age- and education-matched healthy individuals served as controls (n = 14). Test results were compared to population norms and healthy controls. Study participants completed self-reported questionnaires evaluating fatigue, depression, anxiety, quality of life and cognitive function. Subjects underwent neurocognitive evaluation, assessing processing speed, memory, attention, executive functions and intelligence domains. The present study included 51 HLS with a median age of 28 years, mean education of 14·5 ± 2·5 years. Complaints related to cognitive deterioration and fatigue were significantly more severe and frequent in HLS compared to healthy controls. Objective neurocognitive evaluation demonstrated that 30% of HLS were impaired in ≥2 cognitive domains. In conclusion, the present study demonstrates that fatigue and cognitive impairment, predominantly in executive functions and memory, constitute frequent and alarming findings in HLS. These adverse effects can persist and exert an impact on all aspects of life.

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“…Medical information about the general process and outcomes of the transplant, donor sources, medications, timelines, and risks and benefits of the procedure are usually provided after induction therapy has been successful. However, older people have more difficulties processing and remembering information than younger ones (Posma et al 2009), and cognition may have been affected further by the chemotherapy that has been given (Williams et al 2016). It is important, therefore, to provide education about HCT, which is gradual and repeated during induction and, afterwards, presented using plain language, empowering the older patient to make the decision about transplant (Randall et al 2016).…”

Section: Decision-makingmentioning

confidence: 99%

Transplantation Through the Generations

Castagna

Mcmonagle²,

Eeltink

et al. 2017

The European Blood and Marrow Transplantation Textbook for Nurses

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Biologically, a child is a human being between the stages of birth and puberty. The legal definition of child generally refers to a minor, otherwise known as a person younger than the age of majority (Oxford University Press (Accessed 5th January 2013)). The ability to cure children with cancer has radically improved over the recent decades. Today, more than 80% of children with cancer are cured of their disease (Franklin 2014). This incredible achievement is one of the greatest triumphs in the history of medicine and is the result of numerous factors, including developments in paediatric haematopoietic stem cell transplantation (HSCT). Treatment advances for the sick child have been accomplished in various cancer treatments including chemotherapy, surgery, radiotherapy and HSCT. Whilst these therapies have vastly improved outcomes in childhood cancers, there remains scope for further improvement. Keywords HSCT • Paediatric 8.1.1 The Role of EBMT in Paediatric HSCT Changes in HSCT approaches are responsible for progress in this particular area. The role and status of transplantation have evolved. It is no longer considered a salvage therapy for patients in desperate circumstances but is now the treatment of choice for many diseases. The history of paediatric HSCT in Europe began in Poland in 1949 (Raszek-Rosenbusch), with therapeutic transfusion of bone marrow in children with leukaemia and other blood diseases. Subsequent developments in paediatric HSCT were driven on by the creation in 1974, of

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What is known and unknown about chemotherapy‐related cognitive impairment in patients with haematological malignancies and areas of needed research

Cited by 63 publications

References 69 publications

Cognitive compensatory processes of older, clinically fit patients with hematologic malignancies undergoing chemotherapy: A longitudinal cohort study

Cognitive compensatory processes of older, clinically fit patients with hematologic malignancies undergoing chemotherapy: A longitudinal cohort study

Cognitive impairment in hodgkin lymphoma survivors

Transplantation Through the Generations

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