Cognitive impairment in hematology patients planned for chimeric antigen receptor T-cell therapy
- Author(s)
- Kuznetsova, V; Rosenfeld, H; Sales, C; Van Der Linde, S; Roos, I; Roberts, S; D'Aprano, F; Loi, SM; Dowling, M; Dickinson, M; Kalincik, T; Harrison, SJ; Malpas, CB; Anderson, MA;
- Journal Title
- Expert Review of Hematology
- Publication Type
- Online publication before print
- Abstract
- BACKGROUND: Chimeric antigen receptor T-cell (CAR-T) therapy is used to treat several types of relapsed and refractory hematological malignancies and is associated with cognitive side-effects. The accurate diagnosis of cognitive impairment following CAR-T requires knowledge of baseline cognitive status prior to the therapy. RESEARCH DESIGN AND METHODS: Adult patients with advanced hematologic or solid organ malignancies underwent cognitive assessment, including a self-report questionnaire of psychopathology and subjective cognitive function, prior to receiving CAR-T. A subset of individuals also completed the Montreal Cognitive Assessment (MoCA) to examine utility of cognitive screening. RESULTS: Of 60 patients included, 16 (27%) had cognitive impairment, with six unique patterns of dysfunction. Memory impairment was the most common finding (15%). Impaired patients were more likely to have B-cell acute lymphoblastic leukemia (p = 0.024, BF(10) = 9.30), be younger (p = 0.007, BF(10) = 7.76), have bone marrow involvement (p = 0.037, BF(10) = 5.18), or have evidence of psychopathology (p = 0.004, BF(10) = 31.30). Analyses did not support the utility of cognitive screening. Of those patients who completed a self-report measure of psychopathology, nine (16%) were elevated on at least one symptom domain. CONCLUSIONS: The findings demonstrate a broad spectrum of cognitive and psychological symptoms, emphasizing the importance of baseline evaluation for detecting cognitive symptoms that might arise after CAR-T.
- Keywords
- Cognitive dysfunction; adoptive; hematologic neoplasms; immunotherapy; neuropsychology; neurotoxicity syndromes; psychopathology
- Department(s)
- Haematology
- Publisher's Version
- https://doi.org/10.1080/17474086.2025.2542867
- Open Access at Publisher's Site
https://doi.org/10.1080/17474086.2025.2542867- Terms of Use/Rights Notice
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Creation Date: 2025-08-22 08:45:18
Last Modified: 2025-08-22 08:47:41