Neuropsychological outcome in very young hematopoietic SCT recipients in relation to pretransplant conditioning.
Stem cell transplantation involves conditioning with TBI and/or intensive chemotherapy, which may cause long-term neuropsychological deficits, particularly in children treated at a very young age. The aim of this study was to investigate whether very young children who receive chemotherapy-based conditioning only (BUCY) may have a more favorable neuropsychological outcome than children conditioned with TBI-CY. Twenty-two children who underwent allogeneic SCT at 0.4-3.6 years of age were subject to an extensive neuropsychological assessment at an average of 6.5 years post-therapy. The test results of 10 children exposed to BU were compared to the results of 12 children who had received TBI. Ten of them had received single-dose TBI, whereas two had received fractionated TBI. The BU group performed at age level on verbal measures, but tended to score below age level in the executive and visuo-spatial domains (P<0.01). By comparison, children treated with TBI had more pervasive neuropsychological impairments, including motor deficits (P<0.01) and varying degrees of perceptual (P<0.05), executive and cognitive (P<0.05) problems. In conclusion, children transplanted at a very young age had a more favorable neuropsychological development if conditioned with BUCY than if conditioned with single-dose TBI-CY.
Smedler
A-C
AC
Department of Psychology, Stockholm University, Stockholm, Sweden. acsr@psychology.su.se
Winiarski
J
J
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D020233:Gait Disorders, Neurologic / Q000453:epidemiology* / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000523:psychology*; D006801:Humans; D007223:Infant; D008297:Male; D010468:Perceptual Disorders / Q000453:epidemiology* / Q000209:etiology; D019172:Transplantation Conditioning / Q000009:adverse effects* / Q000523:psychology; D014184:Transplantation, Homologous; D014916:Whole-Body Irradiation / Q000009:adverse effects