Predictors of neuropsychological change in patients with chronic myelogenous leukemia and myelodysplastic syndrome

Abstract

This study examined the course of neuropsychological functioning in patients with chronic myelogeous leukemia (n = 91) or myelodysplastic syndrome (n = 15) who underwent standard treatment for their disease or allogeneic hematopoietic stem cell transplantation (HSCT) at baseline, 12 months, and 18 months post-treatment. At baseline, 23% of the participants (n = 75) in the longitudinal sample had Z-scores on at least one of the neuropsychological tests that were <1.4. Participants in the study showed improvement over baseline at the 12 and 18 months assessments. The average Z-scores for the six cognitive domains in the longitudinal data set over the course of the study ranged from -0.89 to 0.59. Significant predictors of change in neuropsychological test scores included age, with older participants showing less improvement over time. Other predictors included baseline cognitive domains (language, memory, and attention), previous cocaine use, disease status, intelligence quotient, and quality of life measures. Findings support previous studies in patients with hematological malignancies who showed cognitive impairments at baseline prior to HSCT. However, there was little evidence for further cognitive decline over the course of 18 months.

Keywords: Cancer; Cancer treatment; Cognition; Hematological malignancy; Hematopoietic stem cell transplantation; Neuropsychology.

Fig. 1.

Percent abnormal Z-scores (Z ≤ −1.4) for the six cognitive domains at baseline and 12 and 18 months follow-up in the longitudinal data set.