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Biol Blood Marrow Transplant. 2018 Feb;24(2):228-241. doi: 10.1016/j.bbmt.2017.09.004. Epub 2017 Sep 20.

Neurocognitive Dysfunction in Hematopoietic Cell Transplant Recipients: Expert Review from the Late Effects and Quality of Life Working Committee of the Center for International Blood and Marrow Transplant Research and Complications and Quality of Life Working Party of the European Society for Blood and Marrow Transplantation.

Author information

1
Shands HealthCare and University of Florida, Gainesville, Florida. Electronic address: dlynchkelly@ufl.edu.
2
Divsison of Pediatrics Hematology, Children's Hospital of Orange County, Orange, California.
3
University Hospital Puerta de Hierro, Madrid, Spain.
4
Blood and Marrow Transplant Program and Host Defense Program, Division of Hematology, Nationwide Children's Hospital, Columbus, Ohio; Blood and Marrow Transplant Program and Host Defense Program, Division of Oncology, Nationwide Children's Hospital, Columbus, Ohio; Blood and Marrow Transplant Program and Host Defense Program, Division of Bone Marrow Transplant and Infectious Diseases, Nationwide Children's Hospital, Columbus, Ohio.
5
Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
6
Vanderbilt University Medical Center, Nashville, Tennessee.
7
Blood and Marrow Transplant Program, Massachusetts General Hospital, Boston, Massachusetts.
8
The Children's Hospital at Westmead, New South Wales, Australia.
9
Scripps Blood & Marrow Transplant Program, La Jolla, California.
10
Shands HealthCare and University of Florida, Gainesville, Florida.
11
University Hospital of Leuven, Leuven, Belgium.
12
Division of Stem Cell Transplantation and Regenerative Medicine, Lucille Packard Children's Hospital, Stanford School of Medicine, Palo Alto, California.
13
Division of Pediatric Hem/Onc/BMT, Children's Mercy Kansas City, Kansas City, Missouri; UMKC School of Medicine, Kansas City, Missouri.
14
Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan; Nagoya University Graduate School of Medicine, Nagoya, Japan.
15
Medical University of Warsaw, Warsaw, Poland.
16
Department of Psychosocial Oncology and Rehabilitation, Tom Baker Cancer Centre, Calgary, Alberta, Canada.
17
Ottawa Hospital Blood and Marrow Transplant Program and the Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
18
Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
19
Case Western Reserve School of Medicine, Cleveland, Ohio; Rainbow Babies and Children's Hospital, Cleveland, Ohio.
20
Tom Baker Cancer Centre, Calgary, Alberta, Canada.
21
Oregon Health and Science University, Portland, Oregon.
22
Division of Experimental Medicine, Department of Medicine, Imperial College London, Hematology Research Centre, London, United Kingdom.
23
Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.
24
Division of Pediatric Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, Missouri.
25
Tufts University Medical Center, Boston, Massachusetts.
26
Utah Blood and Marrow Transplant Program Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.
27
Department of Medicine, University of Rochester Medical Center, Rochester, New York.
28
Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
29
Hematology Division and BMT, Chaim Sheba Medical Center, Tel Hashomer, Israel; Tel Aviv University, Tel Aviv, Israel.
30
Texas Transplant Institute, San Antonino, Texas.
31
Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
32
Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
33
Pennsylvania State University, University Park, Pennsylvania.
34
Dana Farber Cancer Institute, Boston, Massachusetts.
35
Department Clinical Haematology and Bone Marrow Transplantation, Royal Melbourne Hospital, Victoria, Australia.
36
Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
37
Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, Washington.
38
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
39
Hematopoietic Transplantation Section, Hematology Branch, National Heart, Lung, and Blood Institute, Bethesda, Maryland.

Abstract

Hematopoietic cell transplantation (HCT) is a potentially curative treatment for children and adults with malignant and nonmalignant diseases. Despite increasing survival rates, long-term morbidity after HCT is substantial. Neurocognitive dysfunction is a serious cause of morbidity, yet little is known about neurocognitive dysfunction after HCT. To address this gap, collaborative efforts of the Center for International Blood and Marrow Transplant Research and the European Society for Blood and Marrow Transplantation undertook an expert review of neurocognitive dysfunction after HCT. In this review we define what constitutes neurocognitive dysfunction, characterize its risk factors and sequelae, describe tools and methods to assess neurocognitive function in HCT recipients, and discuss possible interventions for HCT patients with this condition. This review aims to help clinicians understand the scope of this health-related problem, highlight its impact on well-being of survivors, and help determine factors that may improve identification of patients at risk for declines in cognitive functioning after HCT. In particular, we review strategies for preventing and treating neurocognitive dysfunction in HCT patients. Finally, we highlight the need for well-designed studies to develop and test interventions aimed at preventing and improving neurocognitive dysfunction and its sequelae after HCT.

KEYWORDS:

Bone marrow transplantation; Cognition; Cognitive function; Hematology oncology; Hematopoietic cell transplantation; Neurocognitive dysfunction

PMID:
28939455
PMCID:
PMC5768142
[Available on 2019-02-01]
DOI:
10.1016/j.bbmt.2017.09.004

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