Abstract：
Pediatric hematological cancer survivors who undergo hematopoietic stem cell transplantation (HSCT) may experience long-term neurocognitive impairments. This systematic review aims to assess the neurocognitive outcomes in pediatric hematological cancer survivors at least 5 years post-HSCT.
A comprehensive search was conducted in multiple databases, including PubMed, ScienceDirect, Cochrane Library, and ClinicalTrials.gov, until October 2022. Relevant studies assessing the neurocognitive affect after 5 years of HSCT were identified and included in the review. The quality of included studies was assessed using the ROBINS-I tool to evaluate the risk of bias.
A total of five studies met the inclusion criteria and were included in the review. The studies consistently demonstrated adverse effects of HSCT on neurocognitive outcomes in pediatric hematological cancer survivors after 5 years of the treatment. The most prominent impact was observed on global cognitive outcomes, including intelligence, attention, memory, and executive functioning. Specific cognitive domains, such as processing speed and academic achievement, were also significantly affected. Several studies reported a relationship between HSCT-related factors (e.g., age at transplantation, radiation therapy, graft-versus-host disease) and neurocognitive impairments.
This systematic review provides evidence of the adverse impact of HSCT on neurocognitive outcomes in pediatric hematological cancer survivors at least 5 years post-transplantation. The findings highlight the importance of long-term monitoring and intervention strategies to mitigate these neurocognitive sequelae. Future research should focus on identifying risk factors and developing targeted interventions to optimize the neurocognitive functioning of this vulnerable population. Healthcare professionals involved in the care of pediatric hematological cancer survivors should be aware of these potential long-term neurocognitive effects and incorporate appropriate assessments and interventions into survivorship care plans.
A comprehensive search was conducted in multiple databases, including PubMed, ScienceDirect, Cochrane Library, and ClinicalTrials.gov, until October 2022. Relevant studies assessing the neurocognitive affect after 5 years of HSCT were identified and included in the review. The quality of included studies was assessed using the ROBINS-I tool to evaluate the risk of bias.
A total of five studies met the inclusion criteria and were included in the review. The studies consistently demonstrated adverse effects of HSCT on neurocognitive outcomes in pediatric hematological cancer survivors after 5 years of the treatment. The most prominent impact was observed on global cognitive outcomes, including intelligence, attention, memory, and executive functioning. Specific cognitive domains, such as processing speed and academic achievement, were also significantly affected. Several studies reported a relationship between HSCT-related factors (e.g., age at transplantation, radiation therapy, graft-versus-host disease) and neurocognitive impairments.
This systematic review provides evidence of the adverse impact of HSCT on neurocognitive outcomes in pediatric hematological cancer survivors at least 5 years post-transplantation. The findings highlight the importance of long-term monitoring and intervention strategies to mitigate these neurocognitive sequelae. Future research should focus on identifying risk factors and developing targeted interventions to optimize the neurocognitive functioning of this vulnerable population. Healthcare professionals involved in the care of pediatric hematological cancer survivors should be aware of these potential long-term neurocognitive effects and incorporate appropriate assessments and interventions into survivorship care plans.
摘要：
背景：接受造血干细胞移植（HSCT）的小儿血液肿瘤幸存者可能会经历长期的神经认知障碍。本系统评价旨在评估HSCT后至少5年小儿血液肿瘤幸存者的神经认知结果。
方法：在多个数据库中进行了全面搜索，包括PubMed,ScienceDirect,科克伦图书馆,和ClinicalTrials.gov,直到2022年10月。确定了评估HSCT5年后神经认知影响的相关研究，并将其纳入综述。使用ROBINS-I工具评估纳入研究的质量，以评估偏倚风险。
结果：共有5项研究符合纳入标准，被纳入综述。这些研究一致证明了HSCT对治疗5年后小儿血液肿瘤幸存者神经认知结果的不利影响。最突出的影响是对全球认知结果的影响，包括智力,注意,记忆,和执行功能。特定的认知领域，如处理速度和学术成就，也受到重大影响。几项研究报告了HSCT相关因素之间的关系(例如，移植的年龄，放射治疗,移植物抗宿主病）和神经认知障碍。
结论：本系统综述提供了HSCT对移植后至少5年的小儿血液肿瘤幸存者的神经认知结果的不利影响的证据。研究结果强调了长期监测和干预策略对减轻这些神经认知后遗症的重要性。未来的研究应该集中在识别危险因素和开发有针对性的干预措施，以优化这一弱势群体的神经认知功能。参与儿科血液癌症幸存者护理的医疗保健专业人员应该意识到这些潜在的长期神经认知效应，并将适当的评估和干预措施纳入生存护理计划。
方法：在多个数据库中进行了全面搜索，包括PubMed,ScienceDirect,科克伦图书馆,和ClinicalTrials.gov,直到2022年10月。确定了评估HSCT5年后神经认知影响的相关研究，并将其纳入综述。使用ROBINS-I工具评估纳入研究的质量，以评估偏倚风险。
结果：共有5项研究符合纳入标准，被纳入综述。这些研究一致证明了HSCT对治疗5年后小儿血液肿瘤幸存者神经认知结果的不利影响。最突出的影响是对全球认知结果的影响，包括智力,注意,记忆,和执行功能。特定的认知领域，如处理速度和学术成就，也受到重大影响。几项研究报告了HSCT相关因素之间的关系(例如，移植的年龄，放射治疗,移植物抗宿主病）和神经认知障碍。
结论：本系统综述提供了HSCT对移植后至少5年的小儿血液肿瘤幸存者的神经认知结果的不利影响的证据。研究结果强调了长期监测和干预策略对减轻这些神经认知后遗症的重要性。未来的研究应该集中在识别危险因素和开发有针对性的干预措施，以优化这一弱势群体的神经认知功能。参与儿科血液癌症幸存者护理的医疗保健专业人员应该意识到这些潜在的长期神经认知效应，并将适当的评估和干预措施纳入生存护理计划。
