Chemotherapy-related Cognitive Impairment in Patients with Hodgkin Lymphoma – Pathophysiology and Risk Factors

Česká verzia

Authors: D. Fayette ¹; Ľ. Gahérová ²; H. Mociková ²; J. Marková ²; T. Kozák ²; J. Horáček ¹
Authors place of work: Národní ústav duševního zdraví, Klecany ¹; Interní hematologická klinika 3. LF UK a FN Královské Vinohrady, Praha ²
Published in the journal: Klin Onkol 2017; 30(2): 93-99
Category: Přehledy
doi: https://doi.org/10.14735/amko201793

Summary

Background:
Cognitive impairment (impairment of memory, attention, or concentration) is documented in 17–75% of patients with various malignancies treated with chemotherapeutic agents that worsen quality of life. CRCI affects patients of all ages. The impairment of cognitive function in connection with chemotherapy is usually mild, but an event. relationship with dementia remains to be confirmed. Chemotherapy in combination with radiotherapy in Hodgkin lymphoma can cure 80–90% of patients.

Aim:
This review summarizes the most frequently observed changes in cognitive function in patients suffering from CRCI. The article further describes the possible pathophysiological mechanisms behind these changes and the risk factors that can increase the likelihood of cognitive functional impairment after chemotherapy of malignant tumors. Special attention is given to how this relates to Hodgkin’s lymphoma. We also discuss the neuroprotective factors involved in chemotherapy-related cognitive impairment and its treatment options.

Conclusion:
Changes occur mainly in the ability to learn and remember, in the speed of reactions, and in attention and executive functions. Although CRCI pathophysiological mechanisms are complex and not yet fully understood, the involvement of neurotoxicity, such as that induced by treatment, anemia, higher levels of oxidative stress and inflammatory responses, genetic factors, and reduced brain connectivity is discussed. CRCI is further modified by comorbidities and patient age. Pharmacological and nonpharmacological treatment options for CRCI are outlined.

Key words:
Hodgkin lymphoma – chemotherapy – cognitive impairment – risk factors

The project was supported by the grant of the Agency for the Czech Republic Health Research of the Ministry of Health of the Czech Republic 16-29857A and by the project Sustainability for the National Institute of Mental Health No. LO1611 with a financial support of the Ministry of Education, Youth and Sports of the Czech Republic in the frame of the National Sustainability Programme I.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.

Submitted:
29. 9. 2016

Accepted:
12. 2. 2017

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