Phipps S, Brenner M, Heslop H, Krance R, Jayawardene D, Mulhern R
Division of Behavioral Medicine, St. Jude Children's Research Hospital, Memphis TN, USA.
Bone Marrow Transplant. 1995 Jun;15(6):829-35.
The number of pediatric bone marrow transplantation (BMT) survivors is growing rapidly, yet little is known about the long-term neuropsychologic and psychosocial sequelae of this procedure. Using a prospective, longitudinal design, 64 pediatric patients undergoing BMT were evaluated with standardized measures of global intelligence, academic achievement and selected tests of neuropsychologic function. In addition, adjustment was assessed with parent and patient report measures of social competence, behavior problems and self-esteem. Patients were evaluated prior to admission for BMT, and again in the period 6-12 months after BMT. Longitudinal findings are reported on an initial cohort of 25 survivors. Cognitive and neuropsychologic function remained stable during the study period. The few significant changes from baseline which were observed were in the direction of improvement, and may be attributed to practice effects. In contrast, declines were observed in patient social competence, self-esteem and general emotional well-being. BMT conditioning regimens appear not to be associated with significant neuropsychologic impairment in the first year after transplant. However, a longer period of follow-up is necessary before neuropsychologic late-effects can be ruled out. The first year after BMT is characterized by significant psychosocial difficulties for survivors. Adjustment issues may provide a more salient focus of study during this time frame.
儿童骨髓移植（BMT）幸存者的数量正在迅速增长，但对于该手术的长期神经心理和社会心理后遗症却知之甚少。采用前瞻性纵向设计，对64名接受BMT的儿科患者进行了全球智力、学业成绩的标准化测量以及神经心理功能的特定测试评估。此外，还通过家长和患者报告的社会能力、行为问题和自尊测量来评估适应情况。在患者接受BMT入院前进行评估，并在BMT后6至12个月期间再次评估。报告了最初25名幸存者队列的纵向研究结果。在研究期间，认知和神经心理功能保持稳定。观察到的与基线相比的少数显著变化是朝着改善的方向，可能归因于练习效应。相比之下，患者的社会能力、自尊和总体情绪幸福感出现了下降。BMT预处理方案似乎与移植后第一年的显著神经心理损害无关。然而，在排除神经心理迟发效应之前，需要更长时间的随访。BMT后的第一年，幸存者面临着显著的社会心理困难。在此时间段内，适应问题可能成为更突出的研究重点。
