Department of Translational & Clinical Research, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, India.
Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India.
Clin Transplant. 2024 Jan;38(1):e15193. doi: 10.1111/ctr.15193. Epub 2023 Nov 15.
Pediatric hematological cancer survivors who undergo hematopoietic stem cell transplantation (HSCT) may experience long-term neurocognitive impairments. This systematic review aims to assess the neurocognitive outcomes in pediatric hematological cancer survivors at least 5 years post-HSCT.
A comprehensive search was conducted in multiple databases, including PubMed, ScienceDirect, Cochrane Library, and ClinicalTrials.gov, until October 2022. Relevant studies assessing the neurocognitive affect after 5 years of HSCT were identified and included in the review. The quality of included studies was assessed using the ROBINS-I tool to evaluate the risk of bias.
A total of five studies met the inclusion criteria and were included in the review. The studies consistently demonstrated adverse effects of HSCT on neurocognitive outcomes in pediatric hematological cancer survivors after 5 years of the treatment. The most prominent impact was observed on global cognitive outcomes, including intelligence, attention, memory, and executive functioning. Specific cognitive domains, such as processing speed and academic achievement, were also significantly affected. Several studies reported a relationship between HSCT-related factors (e.g., age at transplantation, radiation therapy, graft-versus-host disease) and neurocognitive impairments.
This systematic review provides evidence of the adverse impact of HSCT on neurocognitive outcomes in pediatric hematological cancer survivors at least 5 years post-transplantation. The findings highlight the importance of long-term monitoring and intervention strategies to mitigate these neurocognitive sequelae. Future research should focus on identifying risk factors and developing targeted interventions to optimize the neurocognitive functioning of this vulnerable population. Healthcare professionals involved in the care of pediatric hematological cancer survivors should be aware of these potential long-term neurocognitive effects and incorporate appropriate assessments and interventions into survivorship care plans.
接受造血干细胞移植（HSCT）的儿科血液病幸存者可能会出现长期的神经认知障碍。本系统评价旨在评估 HSCT 后至少 5 年的儿科血液病幸存者的神经认知结局。
在多个数据库（包括 PubMed、ScienceDirect、Cochrane Library 和 ClinicalTrials.gov）中进行了全面检索，检索截至 2022 年 10 月。确定并纳入了评估 HSCT 后 5 年神经认知影响的相关研究。使用 ROBINS-I 工具评估纳入研究的质量，以评估偏倚风险。
共有 5 项研究符合纳入标准并纳入本评价。这些研究一致表明，HSCT 对儿科血液病幸存者在治疗后 5 年的神经认知结局有不良影响。最明显的影响是在整体认知结局上，包括智力、注意力、记忆力和执行功能。处理速度和学业成绩等特定认知领域也受到显著影响。几项研究报告了 HSCT 相关因素（如移植时的年龄、放射治疗、移植物抗宿主病）与神经认知障碍之间的关系。
本系统评价提供了证据，表明 HSCT 对 HSCT 后至少 5 年的儿科血液病幸存者的神经认知结局有不良影响。研究结果强调了长期监测和干预策略的重要性，以减轻这些神经认知后遗症。未来的研究应重点确定风险因素，并制定有针对性的干预措施，以优化这一脆弱人群的神经认知功能。参与儿科血液病幸存者护理的医疗保健专业人员应了解这些潜在的长期神经认知影响，并将适当的评估和干预纳入生存护理计划。
