Pediatric blood & cancer · 2025
Neuropsychological Functioning in Pediatric Patients With Leukemia or Lymphoma Treated With CAR T-Cell Therapy: A Retrospective Chart Review.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Peterson Rachel K, Hess Colleen T, Sy Megan, Jacobson Lisa A, Janzen Laura, Hammer Shannon N, Schofield Hannah-Lise T
Аннотация
BACKGROUND: Chimeric antigen receptor (CAR) T-cell therapy has emerged as a treatment option for pediatric and young adult patients with relapsed or refractory acute lymphoblastic leukemia and non-Hodgkin's lymphoma. However, limited information is available regarding the neuropsychological sequelae associated with this treatment.
PROCEDURE: This study utilized a multisite, retrospective chart review methodology to describe neuropsychological functioning of pediatric patients prior to and following CAR T-cell infusion.
RESULTS: In the pre-infusion cohort (n = 26), 39% demonstrated weaknesses (characterized as > 1 SD below the normative mean) on at least one neuropsychological measure, most typically set-shifting, visual motor integration, sustained attention, phonemic fluency, graphomotor processing speed, auditory working memory, and nondominant fine motor functions. In the post-infusion cohort (n = 23), 33% demonstrated impairments (characterized as ≥ 1.5 SD below the normative mean) in full-scale intelligence quotient, graphomotor processing speed, visual-motor integration, and fine motor speeded dexterity. Weaknesses (> 1 SD below the normative mean) in sustained attention, narrative verbal memory, academic skills, verbal fluency, and visual memory were also evident in this cohort. In the pre-post-infusion cohort (n = 6), 83% demonstrated at least one neuropsychological score that declined across time; however, there was variability in the neuropsychological domains that changed. As a group, academic skills declined over time.
CONCLUSIONS: While conclusions should be tempered given the heterogeneity of the patient population, these findings offer preliminary evidence for specific neuropsychological outcomes in pediatric patients treated with CAR T-cell therapy. Limitations and implications for future practice are discussed.
PROCEDURE: This study utilized a multisite, retrospective chart review methodology to describe neuropsychological functioning of pediatric patients prior to and following CAR T-cell infusion.
RESULTS: In the pre-infusion cohort (n = 26), 39% demonstrated weaknesses (characterized as > 1 SD below the normative mean) on at least one neuropsychological measure, most typically set-shifting, visual motor integration, sustained attention, phonemic fluency, graphomotor processing speed, auditory working memory, and nondominant fine motor functions. In the post-infusion cohort (n = 23), 33% demonstrated impairments (characterized as ≥ 1.5 SD below the normative mean) in full-scale intelligence quotient, graphomotor processing speed, visual-motor integration, and fine motor speeded dexterity. Weaknesses (> 1 SD below the normative mean) in sustained attention, narrative verbal memory, academic skills, verbal fluency, and visual memory were also evident in this cohort. In the pre-post-infusion cohort (n = 6), 83% demonstrated at least one neuropsychological score that declined across time; however, there was variability in the neuropsychological domains that changed. As a group, academic skills declined over time.
CONCLUSIONS: While conclusions should be tempered given the heterogeneity of the patient population, these findings offer preliminary evidence for specific neuropsychological outcomes in pediatric patients treated with CAR T-cell therapy. Limitations and implications for future practice are discussed.