Long-Term Impact of TBI on Cognitive Functioning in Pediatric HCT

Using total-body irradiation (TBI) in pre-transplant conditioning regimens lowers cognitive ability, according to a study of 315 pediatric hematopoietic cell transplant (HCT) recipients. At baseline, intelligence quotient (IQ) levels were comparable in recipients who received TBI during conditioning (52.1%) and those who did not. At 5 years post-transplant, however, patients <3 years old at baseline who received TBI demonstrated a significantly lower IQ than those who did not receive TBI (p=0.05). Patients in this young age group who did not receive TBI also experienced some decline in cognitive functioning, but they largely recovered their functioning in subsequent years, whereas patients receiving TBI did not. The authors conclude that “young patients who receive TBI may benefit from early intervention efforts to minimize cognitive losses during the first year after HCT and to maximize potential recovery.”

Willard VW, et al. J Clin Oncol

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