In contrast to full-intensity stem cell transplants, reduced-intensity stem-cell transplants appear to have little effect on cognitive function. These results were presented at the 2013 Annual Meeting of the American Society of Hematology.
Stem cells are early blood-forming cells that grow and mature in the bone marrow, but can circulate in the blood. When high-dose therapy is used to treat cancer, one of the major side effects is destruction of the stem cells living in the bone marrow. A stem cell transplant (infusion of stem cells that were collected from the patient prior to treatment or from a donor) replaces stem cells in order to hasten blood cell production and immune system recovery.
When the stem cells come from a donor, it is referred to as an allogeneic stem cell transplant. This procedure typically involves very high doses of chemotherapy or radiation therapy, but lower doses may be used in some cases. When lower doses are used, it’s referred to as a reduced-intensity stem cell transplant.
To evaluate the effects of full-intensity and reduced-intensity stem cell transplantation on mental functioning, researchers conducted a study among 242 patients with leukemia, lymphoma, or another type of blood cancer. The median age of the patients was 49 years. Roughly half received a reduced-intensity stem cell transplant and half received a full-intensity transplant.
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Patients completed neuropsychiatric tests prior to the stem cell transplant, and then repeated the tests six months, one year, and two years after the stem cell transplant. Results were compared with those of healthy people of a similar age and sex.
Post-transplant cognitive function was better among the patients who underwent a reduced-intensity transplant than among the patients who underwent a full-intensity transplant. The level of cognitive function in patients who underwent a reduced-intensity transplant was similar to that of the healthy comparison group.
These results suggest that reduced-intensity stem cell transplants have less of an effect on mental functioning than full-intensity stem cell transplants. Many factors, however, determine which type of transplant is best for which patient.
Reference: Bosworth A, Chen Y, Patel SK et al. Full-Intensity Transplantation and Short Telomeres Increase The Risk Of Cognitive Impairment After Allogeneic Hematopoietic Cell Transplantation (HCT) – Results Of a Prospective Longitudinal Study. Presented at the 55th ASH Annual Meeting and Exposition. New Orleans, LA. December 7-10, 2013. Abstract 913.
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