Putative mechanisms of cognitive dysfunction in chemotherapy-naïve diffuse large B-cell lymphoma: a case report and review of the literature.
Cognitive impairment is now recognized as a frequent consequence of treatments for cancers localized outside the central nervous system (CNS). In contrast, little attention has been given to the potentially deleterious cognitive effects from non-CNS cancers themselves. The present case study proposes that cognitive deficits occur in a subset of treatment-naive patients with diffuse large B-cell lymphoma in whom no gross evidence of lymphoma-related CNS involvement is apparent. Evidence is presented from a case study and elaborate putative mechanisms centering on deleterious effects of B-cell-mediated inflammatory cytokine secretion on neurons. Moreover, this case study speculates that genetic variability involving apolipoprotein E or other factors may mediate cognitive variability among these patients.
Cercy
Steven P
SP
Mental Health Service, Veterans Affairs New York Harbor Healthcare System, 423 East 23rd Street, New York, NY 10010, USA. steven.cercy@va.gov
Bronson
Brian
B
D001057:Apolipoproteins E / Q000235:genetics / Q000502:physiology; D001402:B-Lymphocytes / Q000502:physiology; D001921:Brain / Q000473:pathology; D003072:Cognition Disorders / Q000209:etiology* / Q000235:genetics / Q000276:immunology / Q000473:pathology; D016207:Cytokines / Q000502:physiology; D005838:Genotype; D006801:Humans; D007249:Inflammation / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications / Q000235:genetics / Q000473:pathology / Q000523:psychology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011110:Polymorphism, Genetic / Q000502:physiology
D001057:Apolipoproteins E; D016207:Cytokines