Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Most patients recover from 'chemo-brain' by 5 years after stem cell transplant

04.05.2011
However, fine-motor and memory deficits persist for some after 5 years

Many patients who undergo bone marrow or blood stem cell transplantation to treat blood cancers or a "pre-leukemic" condition called myelodysplasia experience a decline in mental and fine motor skills due to the toll of their disease and its treatment.

A new study led by researchers at Fred Hutchinson Cancer Research Center, published in the May 2, 2011 online edition of the Journal of Clinical Oncology, found that overall, these effects are largely temporary and that most patients can expect a return to normal motor and memory function within five years. However, the study also found that deficits in fine motor skills and verbal memory remained for a significant percentage of patients and warrant more attention by health care providers.

It has been widely documented that powerful chemotherapy drugs that leukemia and lymphoma patients receive prior to hematopoietic transplantation (HCT) – as well as medicines to combat graft-versus-host disease – can impact motor and memory skills. The purpose of the new study, led by Karen Syrjala, Ph.D., director of Biobehavioral Sciences at the Hutchinson Center, was to determine whether patients recover from these neurocognitive deficits within five years of transplant.

For the study, Syrjala and colleagues identified 92 patients who had received an allogeneic (cells from a donor other than themselves) bone marrow or stem cell transplant for chronic myeloid leukemia, acute leukemia, lymphoma or myelodysplastic syndrome, an umbrella term for several "pre-cancerous" diseases in which the bone marrow does not function normally.

For comparison purposes, the patients were asked to nominate a case-matched control, such as a sibling or friend of the same gender and similar age who had neither received a transplant nor were in active cancer treatment. The transplant patients and control subjects were then given a battery of tests – all by the same test giver – to assess their memory and motor skills.

The tests included immediate and delayed recall of a list of words, saying out loud as many words as possible that begin with specific letters, the ability to sequentially link letters and numbers on paper, learning to match numbers and symbols and write the symbols on paper to match random numbers, and putting toothpick-sized pegs into holes as fast as possible.

Analysis of the tests results showed that most patients made substantial improvements in neurocognitive function over the five years after their transplant. "However, contrary to expectations, neither motor dexterity nor verbal learning and retention improved between one and five years," the authors wrote. "Deficits were most notable in motor speed and dexterity."

Described as mostly mild, the neurocognitive dysfunctions remained at five years for twice as many long-term survivors (41.5 percent) versus controls (19.7 percent).

Syrjala said the researchers were surprised by the evidence of continued impairment.

"We really thought the rates would be lower," Syrjala said. "We were thrilled to see that people recovered substantially, but we also were surprised that so many people did continue to have measurable deficits in some areas even after five years."

Syrjala said the reasons for persistent deficits are unknown and more research is needed to examine the causes. One theory is that some cancers, especially leukemia and lymphoma, are "whole-body" cancers because blood circulates throughout the body and these diseases may cause their own neurocognitive impacts, in addition to what chemotherapy may contribute.

"The major clinical implication of this research is to assure HCT recipients and their health care providers that further progress will occur in their information processing capacity between one and five years after treatment," the authors wrote. "However, it is equally important to validate for long-term survivors that not all HCT recipients fully recover neurocognitive function by five years. These results provide further indication of the need for cognitive rehabilitation strategies after one year for those residual deficits."

The investigation is the first to prospectively follow the same group of patients for five years for any cancer, according to the authors. The study builds upon previous findings by Syrjala and colleagues, published in 2004, which followed the same group of patients to one year after transplant. That study also found that neurocognitive impacts of transplantation are largely temporary.

Co-authors on the paper included researchers from the University of Washington School of Medicine and School of Social Work and Arizona Medical Psychology. Grants from the National Cancer Institute funded the research.

At Fred Hutchinson Cancer Research Center, our interdisciplinary teams of world-renowned scientists and humanitarians work together to prevent, diagnose and treat cancer, HIV/AIDS and other diseases. Our researchers, including three Nobel laureates, bring a relentless pursuit and passion for health, knowledge and hope to their work and to the world. For more information, please visit fhcrc.org

Dean Forbes | EurekAlert!
Further information:
http://www.fhcrc.org

More articles from Health and Medicine:

nachricht Malaria Already Endemic in the Mediterranean by the Roman Period
27.07.2017 | Universität Zürich

nachricht Serious children’s infections also spreading in Switzerland
26.07.2017 | Universitätsspital Bern

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Physicists Design Ultrafocused Pulses

Physicists working with researcher Oriol Romero-Isart devised a new simple scheme to theoretically generate arbitrarily short and focused electromagnetic fields. This new tool could be used for precise sensing and in microscopy.

Microwaves, heat radiation, light and X-radiation are examples for electromagnetic waves. Many applications require to focus the electromagnetic fields to...

Im Focus: Carbon Nanotubes Turn Electrical Current into Light-emitting Quasi-particles

Strong light-matter coupling in these semiconducting tubes may hold the key to electrically pumped lasers

Light-matter quasi-particles can be generated electrically in semiconducting carbon nanotubes. Material scientists and physicists from Heidelberg University...

Im Focus: Flexible proximity sensor creates smart surfaces

Fraunhofer IPA has developed a proximity sensor made from silicone and carbon nanotubes (CNT) which detects objects and determines their position. The materials and printing process used mean that the sensor is extremely flexible, economical and can be used for large surfaces. Industry and research partners can use and further develop this innovation straight away.

At first glance, the proximity sensor appears to be nothing special: a thin, elastic layer of silicone onto which black square surfaces are printed, but these...

Im Focus: 3-D scanning with water

3-D shape acquisition using water displacement as the shape sensor for the reconstruction of complex objects

A global team of computer scientists and engineers have developed an innovative technique that more completely reconstructs challenging 3D objects. An ancient...

Im Focus: Manipulating Electron Spins Without Loss of Information

Physicists have developed a new technique that uses electrical voltages to control the electron spin on a chip. The newly-developed method provides protection from spin decay, meaning that the contained information can be maintained and transmitted over comparatively large distances, as has been demonstrated by a team from the University of Basel’s Department of Physics and the Swiss Nanoscience Institute. The results have been published in Physical Review X.

For several years, researchers have been trying to use the spin of an electron to store and transmit information. The spin of each electron is always coupled...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Clash of Realities 2017: Registration now open. International Conference at TH Köln

26.07.2017 | Event News

Closing the Sustainability Circle: Protection of Food with Biobased Materials

21.07.2017 | Event News

»We are bringing Additive Manufacturing to SMEs«

19.07.2017 | Event News

 
Latest News

Programming cells with computer-like logic

27.07.2017 | Life Sciences

Identified the component that allows a lethal bacteria to spread resistance to antibiotics

27.07.2017 | Life Sciences

Malaria Already Endemic in the Mediterranean by the Roman Period

27.07.2017 | Health and Medicine

VideoLinks
B2B-VideoLinks
More VideoLinks >>>