Cognitive impairment in adolescent and young adult cancer patients: Pre-treatment findings of a longitudinal study.

Autor: Chan A; Department of Clinical Pharmacy Practice, University of California Irvine, Irvine, California, USA.; Department of Pharmacy, National Cancer Centre Singapore, Singapore., Cheng I; Department of Pharmacy, National Cancer Centre Singapore, Singapore., Wang C; Department of Pharmacy, National University of Singapore, Singapore., Tan CJ; Department of Pharmacy, National University of Singapore, Singapore., Toh YL; Department of Pharmacy, National University of Singapore, Singapore., Ng DQ; Department of Clinical Pharmacy Practice, University of California Irvine, Irvine, California, USA., Koh YQ; Department of Pharmacy, National University of Singapore, Singapore., Zhou H; Department of Pharmacy, National University of Singapore, Singapore., Foo KM; Department of Pharmacy, KK Women and Children's Hospital, Singapore., Chan RJ; Caring Futures Institutes, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia., Ho HK; Department of Pharmacy, National University of Singapore, Singapore., Chew L; Department of Pharmacy, National Cancer Centre Singapore, Singapore.; Department of Pharmacy, National University of Singapore, Singapore., Farid M; Division of Medical Oncology, National Cancer Centre Singapore, Singapore., Tannock I; Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
Jazyk: angličtina
Zdroj: Cancer medicine [Cancer Med] 2023 Feb; Vol. 12 (4), pp. 4821-4831. Date of Electronic Publication: 2022 Oct 11.
DOI: 10.1002/cam4.5295
Abstrakt: Background: There is little information about cancer-related cognitive impairment (CRCI) in adolescent and young adults (AYA, 15-39 years old) due to its rare incidence. Here, we present the pre-treatment (before chemotherapy or radiotherapy) evaluation of cognitive function and ability of AYA with cancer (AYAC) in a multicentered cohort study.
Methods: Newly diagnosed AYAC and age-matched healthy controls (HC) were recruited between 2018 and 2021. The primary outcome was the comparison of pre-treatment cognitive impairment defined as 2 standard deviations (SDs) below the HC on ≥1 cognitive test, or >1.5 SDs below on ≥2 tests using CANTAB® between AYAC and HC. Secondary outcomes included self-perceived cognitive ability assessed by FACT-Cog v3 and biomarkers (inflammatory cytokines and brain-derived neurotrophic factor [BDNF]).
Results: We recruited 74 AYAC (median age = 34) and 118 HC (median age = 32). On objective cognitive testing, we observed three times more AYAC patients performed poorly on at least 2 cognitive tests compared to HC (40.5% vs. 13.6%, p < 0.001). AYAC self-perceived less degree of cognitive impairment than HC (p < 0.001). However, AYAC perceived a greater impact of cognitive changes on their quality of life compared to HC (p = 0.039). Elevated baseline inflammatory markers (IL-2, IL-4, IL-6, IL-8, IL-10 and IFN-γ) were observed among AYAC compared to HC, and baseline BDNF was lower in AYAC compared to HC. Interaction effects between cancer diagnosis and biomarkers were observed in predicting cognitive function.
Conclusion: With the pre-existence of CRCI and risk factors of neuroinflammation even prior to systemic therapy, AYAC should receive early rehabilitation to prevent further deterioration of cognitive function after initiation of systemic therapies. (ClinicalTrials.gov Identifier: NCT03476070).
(© 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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