Longitudinal neurocognitive effects of nonmyeloablative hematopoietic stem cell transplant among older adolescents and adults with sickle cell disease: A description and comparison with sibling donors.
Emily J Carlson, Nour Al Ghriwati, Pam Wolters and 5 others
PMID 37540620WHAT IT FOUND
Older adolescents and adults with sickle cell disease who had low-intensity stem cell transplant showed no decline in overall thinking, memory or attention.
Some processing speed and body-symptom scores improved, but siblings improved too, so transplant alone is not proven.
Key findings
01For all 47 patients, overall IQ, attention, working memory and verbal learning did not change from baseline to 12 months post-transplant.
02Patients showed better processing speed scores after transplant, but siblings also showed better scores on the same tests.
03Patients reported fewer body symptoms after transplant, while anxiety and depression scores remained stable.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The cognitive substudy used a convenience sample from medical transplant protocols. Only 22 patients had sibling donor data at both time points, so patient-sibling comparisons are limited. The transplant regimens included several drugs and radiation, so the contribution of any single component cannot be separated. Both patients and siblings improved on some processing speed tests, so practice effects may explain the gains. Follow-up was only 12 months, so longer-term cognitive effects are unknown. The patients were generally high functioning and average cognitive performers, which limits generalizability. The sample included culturally diverse and bilingual participants, so test scores may be culturally loaded. No socioeconomic data were collected. The study cannot identify the mechanism of improvement.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that transplant causes faster processing speed. Siblings also improved on the same tests, and the authors note that the gains may be practice effects rather than treatment.