Division of Hematology, Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi", University of Messina, 90100, Messina, Italy.
Unit and School of Geriatrics, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
Expert Rev Hematol. 2020 Apr;13(4):393-404. doi: 10.1080/17474086.2020.1738213. Epub 2020 Mar 10.
: Cognitive impairment caused by chemotherapies, a condition known as chemobrain, is a possible side effect that affects alertness, learning, memory, and concentration.: Chemobrain has been principally investigated as a possible side-effect among cancer patients. However, numerous drugs used to treat hematological malignancies can determine the appearance of chemobrain. In this review, we have examined some commonly used drugs for the treatment of hematological malignancies which are known to have a deleterious action on cognitive functions.Numerous mechanisms have been suggested, comprising the direct neurotoxicity of chemotherapeutic drugs, oxidative stress, genetic predisposition, cytokine-provoked damage, histone modifications, immune alteration, and the action of chemotherapeutic on trophic factors and structural proteins of brain cells.: Cognitive dysfunction provoked by the treatment of hematological diseases is an actual challenge in clinical practice. Actually, there are no totally efficient and innocuous treatments for this syndrome. It is important that further investigations specify the existence of predictors and gravity factors to pre- and post-therapy cognitive change and identify the influence of tumor treatments on the cognitive alterations in long-term, cancer survivors. Moreover, future studies are needed to analyze the interactions between genetic risk, amyloid accumulation, intrinsic brain networks, and chemotherapy.
化疗引起的认知障碍，即所谓的“化疗脑”，是一种可能的副作用，会影响警觉性、学习、记忆和注意力。化疗脑主要被研究为癌症患者的一种可能的副作用。然而，许多用于治疗血液恶性肿瘤的药物会导致化疗脑的出现。在这篇综述中，我们检查了一些常用于治疗血液恶性肿瘤的药物，这些药物已知对认知功能有不良影响。已经提出了许多机制，包括化疗药物的直接神经毒性、氧化应激、遗传易感性、细胞因子引起的损伤、组蛋白修饰、免疫改变以及化疗药物对大脑细胞的营养因子和结构蛋白的作用。血液疾病治疗引起的认知功能障碍是临床实践中的一个实际挑战。实际上，对于这种综合征还没有完全有效和无害的治疗方法。进一步的研究确定预测因子和严重程度因素对于治疗前后认知变化非常重要，并确定肿瘤治疗对长期癌症幸存者认知改变的影响。此外，还需要进行未来的研究来分析遗传风险、淀粉样蛋白积累、内在脑网络和化疗之间的相互作用。
