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Bone Marrow Transplant. 2018 May;53(5):535-555. doi: 10.1038/s41409-017-0055-7. Epub 2018 Jan 17.

Neurocognitive dysfunction in hematopoietic cell transplant recipients: expert review from the late effects and Quality of Life Working Committee of the CIBMTR and complications and Quality of Life Working Party of the EBMT.

Author information

1
Division of Pediatrics Hematology, Children's Hospital of Orange County, Orange, CA, USA. dbuchbinder@choc.org.
2
Shands HealthCare and University of Florida, Gainesville, FL, USA.
3
University Hospital Puerta de Hierro, Madrid, Spain.
4
Blood and Marrow Transplant Program and Host Defense Program, Divisions of Hematology/Oncology/Bone Marrow Transplant and Infectious Diseases, Nationwide Children's Hospital, Columbus, OH, USA.
5
CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
6
Vanderbilt University Medical Center, Nashville, TN, USA.
7
Blood and Marrow Transplant Program, Massachusetts General Hospital, Boston, MA, USA.
8
The Children's Hospital at Westmead, Westmead, NSW, Australia.
9
Scripps Blood & Marrow Transplant Program, La Jolla, CA, USA.
10
Division of Pediatrics Hematology, Children's Hospital of Orange County, Orange, CA, USA.
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, CA, USA.
13
Rainbow Babies and Children's Hospital, Cleveland, OH, USA.
14
Division of Pediatric Hem/Onc/BMT, Children's Mercy Kansas City, Kansas City, Missouri; UMKC School of Medicine, Kansas City, MO, USA.
15
Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.
16
Nagoya University Graduate School of Medicine, Nagoya, Japan.
17
Medical University of Warsaw, Warsaw, Poland.
18
Department of Psychosocial Oncology and Rehabilitation, Tom Baker Cancer Centre, Calgary, AB, Canada.
19
Department of Medicine, School of Medicine, Queen's University, Kingston, ON, K7L 3N6, Canada.
20
The Ottawa Hospital Blood and Marrow Transplant Program and the Ottawa Hospital Research Institute, Ottawa, ON, Canada.
21
Children's Hospital of Philadelphia, Philadelphia, PA, USA.
22
Case Western Reserve School of Medicine, Cleveland, OH, USA.
23
Tom Baker Cancer Centre, Calgary, AB, Canada.
24
Oregon Health and Science University, Portland, OR, USA.
25
Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, UK.
26
Division of Hematology/Oncology, Department of Medicine and Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
27
Division of Pediatric Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
28
Tufts University Medical Center, Boston, MA, USA.
29
Utah Blood and Marrow Transplant Program Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
30
Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
31
Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
32
Hematology Division and BMT, Chaim Sheba Medical Center, Tel Hashomer, Israel.
33
Tel Aviv University, Tel Aviv, Israel.
34
Texas Transplant Institute, San Antonino, TX, USA.
35
Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
36
Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
37
The Pennsylvania State University, University Park, PA, USA.
38
Dana Farber Cancer Institute, Boston, MA, USA.
39
Department Clinical Haematology and Bone Marrow Transplantation, Royal Melbourne Hospital, Parkville, VIC, Australia.
40
Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, USA.
41
Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA, USA.
42
Hematology Branch, National Heart, Lung and Blood Institute, Bethesda, MD, USA.
43
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.

Abstract

Hematopoietic cell transplantation (HCT) is a potentially curative treatment for children and adults with malignant and non-malignant diseases. Despite increasing survival rates, long-term morbidity following HCT is substantial. Neurocognitive dysfunction is a serious cause of morbidity, yet little is known about neurocognitive dysfunction following 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 following 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 to 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. Lastly, we highlight the need for well-designed studies to develop and test interventions aimed at preventing and improving neurocognitive dysfunction and its sequelae following HCT.

PMID:
29343837
PMCID:
PMC5985976
DOI:
10.1038/s41409-017-0055-7
[Indexed for MEDLINE]
Free PMC Article

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