title: A systematic review and meta-analysis of changes in cognitive functioning in adults undergoing hematopoietic cell transplantation.
abstract: Evidence is mixed regarding the effects of hematopoietic cell transplantation (HCT) on changes in cognitive functioning among adults. Meta-analysis, which is designed to help reconcile conflicting findings, has not yet been conducted on studies of adults receiving HCT. To fill this gap, the current study provides a systematic review and meta-analysis of cognitive functioning in adults receiving HCT. A search of PubMed, PsycInfo, CINAHL, and Cochrane Library yielded 732 abstracts, which were independently evaluated by pairs of raters. Seventeen studies were systematically reviewed; 11 were retained for meta-analysis. There was agreement that cognitive impairments are evident for a subset of patients before HCT. Meta-analytical findings of 404 patients revealed no significant changes in cognitive functioning pre- to post HCT (P-values >0.05). Age, time since transplant and TBI were not associated with changes in cognitive functioning. Patients who received autologous transplants were more likely to demonstrate improvements in attention (P=0.004). The systematic review identified several limitations of existing literature, including small, clinically heterogeneous samples. Large, cooperative group studies are needed to address these design limitations. Nevertheless, results from the current meta-analysis suggest that cognitive functioning does not significantly change following HCT.
authors: Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.
authors: K M
authors: KM
authors: Phillips
authors: H L
authors: HL
authors: McGinty
authors: J
authors: J
authors: Cessna
authors: Y
authors: Y
authors: Asvat
authors: B
authors: B
authors: Gonzalez
authors: M G
authors: MG
authors: Cases
authors: B J
authors: BJ
authors: Small
authors: P B
authors: PB
authors: Jacobsen
authors: J
authors: J
authors: Pidala
authors: H S L
authors: HS
authors: Jim
mesh_terms: D003072:Cognition Disorders / Q000209:etiology* / Q000523:psychology*; D018380:Hematopoietic Stem Cell Transplantation / Q000523:psychology*; D006801:Humans; D009369:Neoplasms / Q000523:psychology / Q000601:surgery
references: Cancer. 2007 Oct 1;110(7):1560-7
references: 17685391
references: Cancer. 2009 Oct 1;115(19):4625-35
references: 19551887
references: Eur J Cancer. 2005 May;41(7):1007-16
references: 15862749
references: Bone Marrow Transplant. 1999 Nov;24(10):1121-9
references: 10578162
references: Cancer. 1992 Nov 1;70(9):2288-97
references: 1394058
references: J Clin Oncol. 2007 Apr 1;25(10):1223-31
references: 17401011
references: Arch Clin Neuropsychol. 2009 Nov;24(7):689-98
references: 19767298
references: Cancer. 2002 Jul 1;95(1):183-92
references: 12115332
references: Blood. 2004 Nov 15;104(10):3386-92
references: 15251983
references: Arch Clin Neuropsychol. 2011 Mar;26(2):98-109
references: 21183605
references: Psychooncology. 2013 Jul;22(7):1509-16
references: 22945857
references: Cancer. 2002 Nov 1;95(9):1971-81
references: 12404292
references: Cancer. 2009 Jun 15;115(12):2605-16
references: 19309747
references: Lancet Oncol. 2011 Jul;12(7):703-8
references: 21354373
references: Patient Educ Couns. 2005 Jan;56(1):62-71
references: 15590224
references: J Clin Exp Neuropsychol. 2006 Apr;28(3):283-93
references: 16618620
references: PLoS Med. 2009 Jul 21;6(7):e1000100
references: 19621070
references: Bone Marrow Transplant. 2007 Jun;39(12):789-99
references: 17417661
references: Psychooncology. 2003 Sep;12(6):612-9
references: 12923801
references: J Clin Oncol. 1996 May;14(5):1457-62
references: 8622059
references: Bone Marrow Transplant. 2011 Oct;46(10):1314-20
references: 21339750
references: J Clin Oncol. 2010 Oct 10;28(29):4434-40
references: 20837957
references: Int J Radiat Oncol Biol Phys. 2000 Jan 15;46(2):303-11
references: 10661336
references: Eur J Cancer. 2007 Sep;43(14):2052-9
references: 17719220
references: Bone Marrow Transplant. 2005 Oct;36(8):695-702
references: 16086044
references: J Neurol Neurosurg Psychiatry. 2000 Jan;68(1):36-40
references: 10601399
references: Bone Marrow Transplant. 2010 Jul;45(7):1134-46
references: 20383219
references: Neurology. 2003 Mar 11;60(5):842-8
references: 12629244
references: J Int Neuropsychol Soc. 2007 Jan;13(1):172-7
references: 17166316
references: J Clin Oncol. 2011 Jun 10;29(17):2397-404
references: 21537032
references: Bone Marrow Transplant. 2008 Jan;41(1):79-90
references: 17934527
references: Int J Radiat Oncol Biol Phys. 2000 Dec 1;48(5):1497-501
references: 11121654
references: Semin Clin Neuropsychiatry. 2003 Oct;8(4):201-16
references: 14613048
references: Cancer Invest. 2001;19(8):812-20
references: 11768035
references: Neurology. 2005 Apr 12;64(7):1184-8
references: 15824344