ISSN 1866-8836
Клеточная терапия и трансплантация

PС-02. Cognitive impairment in patients with hemoblastoses during bone marrow transplantation

Tatyana А. Kerpataya, Irina V. Grandilevskaya, Olga V. Ushakova, Alisa G. Volkova

Saint Petersburg State University, Pavlov University, St. Petersburg, Russia

Contact: Tatyana А. Kerpataya, e-mail:

doi 10.18620/ctt-1866-8836-2020-9-3-1-152



Psychological alterations are common in the patients with malignancies, but their expression is scarcely studied after severe chemotherapy and stem cell transplantation. The aim of the study was to evaluate the dynamics of cognitive functions in oncohematological patients undergoing hematopoietic stem cell transplantation (HSCT).

Patients and methods

The design of this study was presented on a classic longitude schedule. Patients gave their consent and performed testing before HSCT, as well as on day +21 and +60. Selection of control points was based on clinical treatment stages. The patients were tested by the methods measuring of short-term and long-term memory indexes (10-word test by Luria), mediated memory (Luria pictograms), logical and mechanical memory. Other psychological techniques assessed the levels of stability, switchability, and attention span (Trail Making Test, PASAT), thinking (Stroop Test), and tests identifying features of the patient’s emotional status, including depression severity, personal anxiety, and situational anxiety (Beck Depression Scale, State-Trait Anxiety Inventory, STAI). The data were processed using the Spearman correlation test and the Wilcoxon T-test.


Most of studied parameters, such as data on mediated, long-term, short-term, mechanical memory were at the lower border of normal ranges, and showed a decrease during the study at the level of tendencies (p<0.1). Studies of attention indexes indicate to their normal level, however, its volume and switchability significantly decrease from the second to the third post-transplant stage (Table 1, p=0.033). When analyzing the average scores of other attention features, one can conclude about their non-significant decrease (Table 1). In the majority of patients (78%, n=33), thinking was characterized by a dominant rigid style of cognitive control and verbal way of information processing throughout the study.

Table 1. Dynamics of attention features in the patients subjected to HSCT


According to the analysis of mean values, the affective sphere before BMT is represented by pronounced depression (12.97 points against normal values of <9, being above normal scores in 70.45% of patients), at the level of a sub-depressive state, as well as moderate situational anxiety (43.23 points); the abovementioned indices showed a gradual decrease. The first feature dropped, corresponding to absence of depressive symptoms (Table 2, p=0.000, p=0.007), the second parameter decreased to the lower limit of moderate values (Table 2, p=0.004, p=0.003).

Table 2. Dynamics of anxiety and depression indexes in the patients after HSCT


The listed characteristics are interrelated, their indicators correlate with each other. Thus, the higher the level of situational anxiety, the higher the severity of depressive symptoms (p=0.044, p=0.032). Concerning the emotional state, one should also add that the patients undergoing second or third transplantation had a higher level of anxiety (46.6 points) on the Day +21 after HSCT, compared to patients who received their first transplant (36.52 points, p=0.045).

The patients who underwent training for cognitive functions demonstrated their better retention, in terms of operational (p=0.023), short-term (p=0.046), logical (p=0.03) memory at a statistically significant level, as well as mediated (p=0.078) and long-term (p=0.081) memory at the trend level.


Thus, thanks to the obtained results of the study, we can confidently talk about the toxic effect of the method of transplantation of hematopoietic stem cells on higher mental functions. Further scientific work in this area should be aimed at creating a specialized interdisciplinary rehabilitation program for oncohematological patients, including psychological support of the patient throughout treatment in order to timely correct the emotional state and train cognitive functions from the moment the preparation for hematopoietic stem cell transplantation begins and until a stable result.


Сognitive impairment, hemoblastosis, bone marrow transplantation.

Volume 9, Number 3

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doi 10.18620/ctt-1866-8836-2020-9-3-1-152

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