Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Jul 19, 2024; 14(7): 1062-1067
Published online Jul 19, 2024. doi: 10.5498/wjp.v14.i7.1062
Clinical study of chemotherapy-related cognitive impairment in patients with non-Hodgkin lymphoma
Qiang-Li Wang, Hai-Yan Xu, Yi Wang, Yin-Ling Wang, Pei-Nan Lin, Zhong-Lei Chen
Qiang-Li Wang, Hai-Yan Xu, Yi Wang, Yin-Ling Wang, Pei-Nan Lin, Zhong-Lei Chen, Department of Oncology and Hematology, Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine, Suzhou 215000, Jiangsu Province, China
Author contributions: Wang QL and Chen ZL designed the study; Wang QL, Chen ZL, Xu HY, Wang Y, Wang YL, and Lin PN performed the research; Wang QL, Chen ZL, Xu HY, Wang Y, Wang YL, and Lin PN contributed new reagents and analytical tools; Wang QL and Chen ZL analyzed the data and wrote the manuscript; All authors have read and approved the final version of the manuscript.
Institutional review board statement: The study was reviewed and approved by the (Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine) Institutional Review Board.
Informed consent statement: All study participants or their legal guardians provided written informed consent prior to their participation in this study.
Conflict-of-interest statement: All authors declare that they have nothing to disclose.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE statement-checklist of items, and the manuscript was prepared and revised according to the STROBE statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhong-Lei Chen, MMed, Associate Chief Physician, Department of Oncology and Hematology, Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine, No. 118 WanSheng Street, Suzhou 215000, Jiangsu Province, China.chenzhonglei163@163.com
Received: April 8, 2024
Revised: May 7, 2024
Accepted: May 30, 2024
Published online: July 19, 2024
Processing time: 94 Days and 18.2 Hours
Abstract
BACKGROUND

Chemotherapy for malignant tumors can cause brain changes and cognitive impairment, leading to chemotherapy-induced cognitive impairment (CICI). Current research on CICI has focused on breast cancer and Hodgkin’s lymphoma. Whether patients with non-Hodgkin’s lymphoma (NHL) undergoing chemotherapy have cognitive impairment has not been fully investigated.

AIM

To investigate whether NHL patients undergoing chemotherapy had cognitive impairments.

METHODS

The study included 100 NHL patients who were required to complete a comprehensive psychological scale including the Brief Psychiatric Examination Scale (MMSE) at two time points: before chemotherapy and within 2 wk of two chemotherapy courses. A language proficiency test (VFT), Symbol Number Pattern Test (SDMT), Clock Drawing Test (CDT), Abbreviated Daily Cognition Scale (ECog-12), Prospective and Retrospective Memory Questionnaire, and Karnofsky Performance Status were used to assess cognitive changes before and after chemotherapy.

RESULTS

The VFT scores for before treatment (BT) and after treatment (AT) groups were 45.20 ± 15.62, and 42.30 ± 17.53, respectively (t -2.16, P < 0.05). The CDT scores were 8 (3.5-9.25) for BT and 7 (2.5-9) for AT groups (Z -2.1, P < 0.05). Retrospective memory scores were 13.5 (9-17) for BT and 15 (13-18) for AT (Z -3.7, P < 0.01). The prospective memory scores were 12.63 ± 3.61 for BT and 14.43 ± 4.32 for AT groups (t -4.97, P < 0.01). The ECog-12 scores were 1.71 (1.25-2.08) for BT and 1.79 (1.42-2.08) for AT groups (Z -2.84, P < 0.01). The SDMT and MMSE values did not show a significant difference between BT and AT groups.

CONCLUSION

Compared to the AT group, the BT group showed impaired language, memory, and subjective cognition, but objective cognition and execution were not significantly affected.

Keywords: Non-Hodgkin’s lymphoma, Hodgkin lymphoma, Lymphoma cognitive impairment, Chemotherapy-related cognitive impairment, Clinical study

Core Tip: The cognitive status of patients with non-Hodgkin’s lymphoma before and after chemotherapy was assessed using various cognitive scales. We observed chemotherapy-related cognitive impairment. Patients with non-Hodgkin’s lymphoma undergoing chemotherapy may experience chemotherapy-related cognitive impairment. The main manifestations were language, memory, and visuospatial dysfunction. Frontal lobe injury was more obvious, but no clear difference was observed in executive function.