Neurocognitive impairment associated with chronic morbidity in long-term survivors of Hodgkin Lymphoma.

Autor:	Phillips NS; Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN., Mulrooney DA; Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN.; Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN., Williams AM; Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN., Liu W; Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN., Khan RB; Department of Pediatric Medicine Division of Neurology, St. Jude Children's Research Hospital, Memphis, TN., Ehrhardt MJ; Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN.; Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN., Folse T; Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN., Krasin M; Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, TN., Srivastava DK; Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN., Ness KK; Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN., Hudson MM; Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN.; Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN., Sabin ND; Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN., Krull KR; Department of Psychology and Biobehavioral Sciences, St. Jude Children's Research Hospital, Memphis, TN.
Jazyk:	angličtina
Zdroj:	Blood advances [Blood Adv] 2023 Dec 12; Vol. 7 (23), pp. 7270-7278.
DOI:	10.1182/bloodadvances.2023010567
Abstrakt:	Thoracic radiation is associated with significant cardiopulmonary morbidities in survivors of long-term Hodgkin lymphoma and may affect neurocognitive outcomes. Survivors (N = 204; 52.5% female; mean [standard deviation] age, 36.6 [8.01] years) treated with thoracic radiation and age-, sex-, and race/ethnicity-matched community controls (N = 205; 51.7% female; age, 36.7 [9.17] years) completed standardized neurocognitive testing, echocardiography, pulmonary function tests, and vascular studies during the same visit. Treatments were abstracted from medical records. Cardiac (ie, left ventricular ejection fraction [LVEF], global longitudinal strain [GLS]), vascular (ie, large and small artery elasticity [SAE]), pulmonary (ie, diffusing capacity of the lungs for carbon monoxide [DLCO] and forced expiratory volume [FEV1]), and chronic health conditions were evaluated for associations with age-adjusted neurocognitive performance using multivariable linear regression. Compared with controls, survivors had lower performance (P < 0.05) in visuomotor (0.11 vs 0.41), visual processing speed (0.25 vs 0.64), short-term recall (-0.24 vs 0.12), and flexibility (-0.04 vs 0.28). Survivors had lower pulmonary (FEV1, DLCOcorr), cardiac (LVEF, GLS), and vascular function (SAE) than controls (all P < 0.001). FEV1 was associated with visuomotor (P = .008) and visual processing speed (P = .05), and flexibility (P = .05). GLS was associated with short-term recall (P = .03). SAE was associated with flexibility (P = .007). Neurocognitive outcomes were also associated with moderate-to-severe neurologic chronic conditions (P < .05). Findings suggest a link between subclinical cardiopulmonary and vascular findings, neurologic morbidity, and neurocognitive impairments. Prevention of health morbidity may benefit neurocognitive outcomes. (© 2023 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.)
Databáze:	MEDLINE
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