Biobehavioral Sciences

Neurotoxicity

Cognitive Function
Principal Investigator: Karen Syrjala, PhD

Several factors elevate the relevance of neurotoxic effects of chemotherapy in selecting treatment regimens for cancer patients. More choices are available for physicians and patients with a possibility that some have lower short or long term toxicity rates. Cancer survivors are living longer, thus treatment effects have greater long term impact. Survivors are remaining on treatment for longer durations in an effort to prevent relapse.

With NCI funding for two cancer survivor grants (CA63030 & CA78990), we have evaluated the cognitive/neuropsychological function of transplant recipients from before to 5 years after HSCT. On average, patients return to pre-transplant levels of function by one year after transplant. However, pre-transplant function is already below normative means for many of those tested. By five years we see continued improvement in information processing speed and word-finding. However, we do not see improvement from one to five years in memory or fine motor dexterity. We are now examining predictors of reduced performance at 5 years after transplant to determine risk factors for long-term cognitive dysfunction.

Acute Cognitive Changes in Marrow Transplantation: Delirium and Competency
Principal Investigator: Jesse Fann, MD, MPH; Co-Investigator: Karen Syrjala, PhD

This American Cancer Society funded study is the first of its kind to establish the incidence, risk factors, and short- and long-term outcomes of delirium in patients receiving stem cell transplantation. In addition, it prospectively studied decisional capacity in a cancer population, using standardized measures. Our long-term goal is to improve upon the prevention, the detection rate and the effective biopsychosocial treatment of delirium in cancer patients.

Fred Hutchinson Cancer Research Center is a world leader in research to prevent, detect and treat cancer and other life-threatening diseases.