Alterations in Memory and Impact on Academic Outcomes in Children Following Allogeneic Hematopoietic Cell Transplantation

• Published in: Archives of clinical neuropsychology Vol. 30; no. 7; pp. 657 - 669
• Main Authors: Lajiness-O'Neill, R, Hoodin, F, Kentor, R, Heinrich, K, Colbert, A, Connelly, J A
• Format: Journal Article
• Language: English
• Published: United States 01.11.2015
• Subjects: Adolescent; Attention Deficit Disorder with Hyperactivity - drug therapy; Attention Deficit Disorder with Hyperactivity - etiology; Child; Child, Preschool; Female; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation - adverse effects; Humans; Learning Disorders - drug therapy; Learning Disorders - etiology; Leukemia - surgery; Male; Memory Disorders - drug therapy; Memory Disorders - etiology; Outcome Assessment (Health Care); Postoperative Complications - etiology; Regression Analysis; Retrospective Studies; Steroids - therapeutic use; HCT; Late effects; Cognition; Processing speed; Allogeneic hematopoietic cell transplantation; Memory
• ISSN: 0887-6177; 1873-5843
• DOI: 10.1093/arclin/acv053

The prevalence of late effects following allogeneic hematopoietic cell transplantation (HCT), a curative treatment for pediatric leukemia, is high: 79% of HCT recipients experience chronic medical conditions. The few extant studies of cognitive late effects have focused on intelligence and are equivocal about HCT neurotoxicity. In an archival study of 30 children (mean transplant age = 6 years), we characterize neuropsychological predictors of academic outcomes. Mean intellectual and academic abilities were average, but evidenced extreme variability, particularly on measures of attention and memory: ∼25% of the sample exhibited borderline performance or lower. Medical predictors of outcome revealed paradoxically better memory associated with more severe acute graft-versus-host disease (GVHD) and associated with steroid treatment. Processing speed and memory accounted for 69% and 61% of variance in mathematics and reading outcomes, respectively. Thus, our findings revealed neurocognitive areas of vulnerability in processing speed and memory following HCT that contribute to subsequent academic difficulties.