title: Post-chemotherapy cognitive impairment in patients with B-cell non-Hodgkin lymphoma: a first comprehensive approach to determine cognitive impairments after treatment with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone or rituximab and bendamustine.
abstract: To assess the effects of chemoimmunotherapy on post-chemotherapy cognitive impairments (PCCI) in patients with B-cell non-Hodgkin lymphoma (NHL), we used objective and subjective measures of cognitive functions in combination with serum parameters and neuroelectric recordings. Self-perceived status of cognition, fatigue and emotional functioning were reduced in patients (n=30) compared to healthy controls (n=10). Cognitive performance was impaired in patients with NHL compared to controls and a norm sample (n=1179). PCCI was more severe in patients treated with rituximab and bendamustine (BR) than in patients who received R in combination with CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) polychemotherapy (R-CHOP). Individual alpha peak frequency and serum brain-derived neurotrophic factor (BDNF) levels in patients with NHL correlated with accuracy in the objective cognition test. Higher serum interleukin-6 (IL-6) concentrations were associated with higher fatigue levels. Patients with NHL and especially those who were treated with BR were affected by PCCI. BDNF and IL-6 might be involved in the pathogenesis of PCCI and fatigue.
authors.affiliation: Department for Molecular and Cellular Sports Medicine.
authors.forename: Philipp
authors.initials: P
authors.lastname: Zimmer
authors.forename: Andreas
authors.initials: A
authors.lastname: Mierau
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Bloch
authors.forename: Heiko K
authors.initials: HK
authors.lastname: Strüder
authors.forename: Thorben
authors.initials: T
authors.lastname: Hülsdünker
authors.forename: Alexander
authors.initials: A
authors.lastname: Schenk
authors.forename: Leonie
authors.initials: L
authors.lastname: Fiebig
authors.forename: Freek T
authors.initials: FT
authors.lastname: Baumann
authors.forename: Moritz
authors.initials: M
authors.lastname: Hahn
authors.forename: Nina
authors.initials: N
authors.lastname: Reinart
authors.forename: Michael
authors.initials: M
authors.lastname: Hallek
authors.forename: Thomas
authors.initials: T
authors.lastname: Elter
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001402:B-Lymphocytes / Q000187:drug effects* / Q000473:pathology; D000069461:Bendamustine Hydrochloride / Q000008:administration & dosage / Q000009:adverse effects; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood; D003072:Cognition Disorders / Q000139:chemically induced / Q000175:diagnosis*; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D004569:Electroencephalography; D005221:Fatigue / Q000139:chemically induced / Q000175:diagnosis; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008228:Lymphoma, Non-Hodgkin / Q000097:blood / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D000069283:Rituximab / Q000008:administration & dosage / Q000009:adverse effects; D011795:Surveys and Questionnaires; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D019208:Brain-Derived Neurotrophic Factor; D015850:Interleukin-6; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D000069461:Bendamustine Hydrochloride; D011241:Prednisone
keywords: Chemobrain; EEG; cognition; cytokines; fatigue; lymphoma