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Pediatric Transplants

Neuropsychological outcome in very young hematopoietic SCT recipients in relation to pretransplant conditioning

Bone Marrow Transplantation volume 42, pages 515–522 (2008)Cite this article

Abstract

Stem cell transplantation involves conditioning with TBI and/or intensive chemotherapy, which may cause long-term neuropsychological deficits, particularly in children treated at a very young age. The aim of this study was to investigate whether very young children who receive chemotherapy-based conditioning only (BUCY) may have a more favorable neuropsychological outcome than children conditioned with TBI-CY. Twenty-two children who underwent allogeneic SCT at 0.4–3.6 years of age were subject to an extensive neuropsychological assessment at an average of 6.5 years post-therapy. The test results of 10 children exposed to BU were compared to the results of 12 children who had received TBI. Ten of them had received single-dose TBI, whereas two had received fractionated TBI. The BU group performed at age level on verbal measures, but tended to score below age level in the executive and visuo-spatial domains (P<0.01). By comparison, children treated with TBI had more pervasive neuropsychological impairments, including motor deficits (P<0.01) and varying degrees of perceptual (P<0.05), executive and cognitive (P<0.05) problems. In conclusion, children transplanted at a very young age had a more favorable neuropsychological development if conditioned with BUCY than if conditioned with single-dose TBI-CY.

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Acknowledgements

We gratefully acknowledge financial support from the Swedish Children's Cancer Foundation (Grant BCF 03/071).

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  1. Department of Psychology, Stockholm University, Stockholm, Sweden

    A-C Smedler

  2. Clintec, Karolinska Institutet, and Children's Hospital, Karolinska University Hospital Huddinge, Stockholm, Sweden

    J Winiarski

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Correspondence to A-C Smedler.

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Smedler, AC., Winiarski, J. Neuropsychological outcome in very young hematopoietic SCT recipients in relation to pretransplant conditioning. Bone Marrow Transplant 42, 515–522 (2008). https://doi.org/10.1038/bmt.2008.217

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