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血液系统恶性肿瘤患者异基因造血干细胞移植后的认知晚期效应。

Cognitive late effects following allogeneic stem cell transplantation in haematological cancer patients.

机构信息

Justice & Society, University of South Australia, Adelaide, SA, Australia.

Department of Haematology, Royal Adelaide Hospital/SA Pathology, Adelaide, SA, Australia.

出版信息

Eur J Cancer Care (Engl). 2021 Sep;30(5):e13448. doi: 10.1111/ecc.13448. Epub 2021 Mar 28.

Abstract

OBJECTIVE

The objective of this exploratory study was to determine the presence and correlates of self-reported cognition in a sample of haematological cancer patients who had undergone allogeneic stem cell transplantation (SCT).

METHODS

Haematological cancer patients (n = 30) who had undergone allogeneic SCT between one and five years previously and age-matched control participants (n = 30) completed questionnaires assessing cognition, affect, sleep quality and fatigue and an assessment of premorbid IQ.

RESULTS

Patients reported significantly poorer perceived cognitive ability (d = 1.12) and greater perceived cognitive impairment (d = 0.96) than controls. Lower fatigue was significantly associated with greater perceived cognitive ability (r = 0.75 patients and controls) and less perceived cognitive impairment (r = 0.80 patients; r = 0.57 controls). Interestingly, depression was significantly correlated with perceived cognitive ability in the control group only (r = 0.80). Hierarchical multiple regressions showed that fatigue was a significant predictor of perceived cognitive ability in patients, accounting for 56% of the variance.

CONCLUSIONS

This study established that self-reported cognitive ability and cognitive impairment was significantly poorer in haematological cancer patients than controls. Furthermore, fatigue was significantly associated with perceived cognitive ability in patients. Future research should focus on identifying interventions that target fatigue in allogeneic SCT recipients in order to improve quality of life throughout survivorship.

摘要

目的

本探索性研究的目的是确定在接受异基因干细胞移植(SCT)的血液癌症患者样本中自我报告认知的存在及其相关性。

方法

接受异基因 SCT 治疗一至五年的血液癌症患者(n=30)和年龄匹配的对照组参与者(n=30)完成了评估认知、情感、睡眠质量和疲劳的问卷以及一项先前智力的评估。

结果

与对照组相比,患者报告的认知能力明显较差(d=1.12),认知障碍明显更严重(d=0.96)。较低的疲劳与更好的认知能力(患者和对照组 r=0.75)和较少的认知障碍(患者 r=0.80;对照组 r=0.57)显著相关。有趣的是,仅在对照组中,抑郁与认知能力显著相关(r=0.80)。分层多元回归显示,疲劳是患者认知能力的重要预测因素,占总方差的 56%。

结论

本研究表明,与对照组相比,血液癌症患者的自我报告认知能力和认知障碍明显更差。此外,疲劳与患者的认知能力显著相关。未来的研究应集中于确定针对异基因 SCT 接受者的疲劳干预措施,以提高整个生存期间的生活质量。

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