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Erschienen in:

04.06.2021

Long-term neurocognitive and quality of life outcomes in survivors of pediatric hematopoietic cell transplant

verfasst von: Natalie L. Wu, Kevin R. Krull, Kara L. Cushing-Haugen, Nicole J. Ullrich, Nina S. Kadan-Lottick, Stephanie J. Lee, Eric J. Chow

Erschienen in: Journal of Cancer Survivorship | Ausgabe 3/2022

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Abstract

Purpose

Pediatric patients who undergo hematopoietic cell transplant (HCT) are at risk for neurocognitive impairments, which can impact quality of life. Given limited long-term studies, we aimed to characterize the late neurocognitive outcomes in a cohort of pediatric HCT survivors.

Methods

Eligible survivors (HCT at age < 21 year and ≥ 1 year post-HCT) completed a 60-question survey of neurocognitive function and quality of life, which included the Childhood Cancer Survivor Study Neurocognitive Questionnaire (CCSS-NCQ) and the Neuro-Quality of Life Cognitive Function Short Form (Neuro-QoL). Analyses of risk factors included univariate comparisons and multivariable logistic regression.

Results

Participants (n = 199, 50.3% female, 53.3% acute leukemia, 87.9% allogeneic transplants) were surveyed at median age of 37.8 years (interquartile range [IQR] 28.5–48.8) at survey and median 27.6 years (IQR 17.0–34.0) from transplant. On the CCSS-NCQ, 18.9–32.5% of survivors reported impairments (Z score > 1.28) in task efficiency, memory, emotional regulation, or organization, compared with expected 10% in the general population (all p < 0.01). In contrast, survivors reported average Neuro-QoL (T score 49.6±0.7) compared with population normative value of 50 (p = 0.52). In multivariable regression, impaired Neuro-QoL (T score < 40) was independently associated with hearing issues (OR 4.97, 95% CI 1.96-12.6), history of stroke or seizure (OR 4.46, 95% CI 1.44-13.8), and sleep disturbances (OR 6.95, 95% CI 2.53–19.1).

Conclusions

Although long-term survivors of pediatric HCT reported higher rates of impairment in specific neurocognitive domains, cognitive quality of life was perceived as similar to the general population. Subsets of survivors with certain co-morbidities had substantially worse neurocognitive outcomes.

Implications for Cancer Survivors

While the long-term impact of pediatric HCT can include neurocognitive deficits, survivors report average cognitive quality of life.

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Titel: Long-term neurocognitive and quality of life outcomes in survivors of pediatric hematopoietic cell transplant
verfasst von: Natalie L. Wu
Kevin R. Krull
Kara L. Cushing-Haugen
Nicole J. Ullrich
Nina S. Kadan-Lottick
Stephanie J. Lee
Eric J. Chow
Publikationsdatum: 04.06.2021
Verlag: Springer US
Erschienen in: Journal of Cancer Survivorship / Ausgabe 3/2022
Print ISSN: 1932-2259
Elektronische ISSN: 1932-2267
DOI: https://doi.org/10.1007/s11764-021-01063-1

Springer Medizin

Long-term neurocognitive and quality of life outcomes in survivors of pediatric hematopoietic cell transplant