title: Alterations in Memory and Impact on Academic Outcomes in Children Following Allogeneic Hematopoietic Cell Transplantation.
abstract: 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.
authors: Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA rlajines@emich.edu.
authors: R
authors: R
authors: Lajiness-O'Neill
authors: Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA.
authors: F
authors: F
authors: Hoodin
authors: Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA.
authors: R
authors: R
authors: Kentor
authors: Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA.
authors: K
authors: K
authors: Heinrich
authors: Department of Psychology, Eastern Michigan University, Ypsilanti, MI, USA.
authors: A
authors: A
authors: Colbert
authors: Department of Pediatric Hematology-Oncology, University of Michigan Health System, Ann Arbor, MI, USA.
authors: J A
authors: JA
authors: Connelly
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007859:Learning Disabilities / Q000188:drug therapy / Q000209:etiology*; D007938:Leukemia / Q000601:surgery; D008297:Male; D008569:Memory Disorders / Q000188:drug therapy / Q000209:etiology*; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000209:etiology*; D012044:Regression Analysis; D012189:Retrospective Studies; D013256:Steroids / Q000627:therapeutic use
chemical_list: D013256:Steroids
keywords: Allogeneic hematopoietic cell transplantation; Cognition; HCT; Late effects; Memory; Processing speed