NEW ORLEANS—Full-intensity hematopoietic cell transplantation (HCT) is followed by cognitive impairments, and among women, telomere length might be a useful prognostic biomarker of risk for impacts on cognitive functioning, according to research presented at the 55th American Society of Hematology Annual Meeting and Exposition.
Patients receiving full-intensity HCT “are at risk for cognitive impairment in executive functioning, processing speed, verbal speed and visual memory; those receiving reduced-intensity HCT are generally spared,” concluded lead study author Alysia Bosworth, at the City of Hope in Duarte, CA, and coauthors. “In addition, telomeric shortening prior to HCT is associated with poorer executive function, processing speed, verbal speed, and working memory in females after HCT, and not males.”
Telomeres are noncoding DNA-protein structures at the ends of chromosomes, which function to protect the integrity of chromosomes’ gene-encoding regions. Telomere shortening is a marker of cellular senescence, tied in several recent studies to unhealthy or stressful lifestyle factors, and is associated with Alzheimer’s disease.
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A total of 242 patients were enrolled in the study, reported coauthor Smita Bhatia, MD, MPH; blood germline DNA telomere lengths were assessed, and participants were administered a battery of cognitive function tests prior to HCT, and again at 6 months, 1 year, and 2 years after HCT. A total of 125 HCT recipients remained in the study for 2 years. Older age, male gender, Hispanic ethnicity, low income, and high levels of fatigue were significant risk factors for cognitive impairment after HCT, the authors noted.
Patients receiving reduced-intensity HCT had significantly better executive function at the 6 month, 1-year, and 2-year follow-ups (P = 0.01), Dr. Bhatia reported.
“Longitudinal multivariate analysis showed a significant association between short telomeres measured prior to HCT and post-HCT cognitive reduction in female (but not male) HCT recipients for executive function, processing speed, verbal speed, and working memory, the researchers reported.
