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霍奇金淋巴瘤幸存者的认知障碍。

Cognitive impairment in hodgkin lymphoma survivors.

机构信息

Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.

Quality Assurance Unit, Rambam Health Care Campus, Haifa, Israel.

出版信息

Br J Haematol. 2018 Sep;182(5):670-678. doi: 10.1111/bjh.15448. Epub 2018 Jul 5.

DOI:10.1111/bjh.15448
PMID:29974933
Abstract

Cancer-related cognitive impairment (CRCI) is commonly reported post-chemotherapy in adults with solid tumours. Hodgkin lymphoma (HL) mostly affects young adults. Data regarding CRCI in HL survivors (HLS) are scarce. The current study aimed to objectively assess CRCI incidence and characteristics in HLS. HLS, who completed first-line (chemotherapy ± radiation) therapy and remained in complete remission for 6 months to 5 years from therapy end, were evaluated. Age- and education-matched healthy individuals served as controls (n = 14). Test results were compared to population norms and healthy controls. Study participants completed self-reported questionnaires evaluating fatigue, depression, anxiety, quality of life and cognitive function. Subjects underwent neurocognitive evaluation, assessing processing speed, memory, attention, executive functions and intelligence domains. The present study included 51 HLS with a median age of 28 years, mean education of 14·5 ± 2·5 years. Complaints related to cognitive deterioration and fatigue were significantly more severe and frequent in HLS compared to healthy controls. Objective neurocognitive evaluation demonstrated that 30% of HLS were impaired in ≥2 cognitive domains. In conclusion, the present study demonstrates that fatigue and cognitive impairment, predominantly in executive functions and memory, constitute frequent and alarming findings in HLS. These adverse effects can persist and exert an impact on all aspects of life.

摘要

癌症相关认知障碍(CRCI)在接受实体瘤化疗的成年人中较为常见。霍奇金淋巴瘤(HL)主要影响年轻人。关于 HL 幸存者(HLS)CRCI 的数据很少。本研究旨在客观评估 HLS 的 CRCI 发生率和特征。评估完成一线(化疗+放疗)治疗且在治疗结束后 6 个月至 5 年内完全缓解的 HLS。选择年龄和教育程度匹配的健康个体作为对照组(n=14)。将测试结果与人群正常值和健康对照组进行比较。研究参与者完成了自评问卷,评估疲劳、抑郁、焦虑、生活质量和认知功能。受试者接受了神经认知评估,评估了处理速度、记忆、注意力、执行功能和智力领域。本研究包括 51 名中位年龄为 28 岁、平均受教育年限为 14.5±2.5 年的 HLS。与健康对照组相比,HLS 报告的认知能力下降和疲劳相关的症状更严重且更频繁。客观的神经认知评估显示,30%的 HLS 在≥2 个认知领域受损。总之,本研究表明疲劳和认知障碍,主要是在执行功能和记忆方面,是 HLS 中常见且令人警惕的表现。这些不良反应可能持续存在,并对生活的各个方面产生影响。

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