Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Cancer-related cognitive impairment in patients with newly diagnosed aggressive lymphoma compared to healthy controls: An exploratory study (#201)

Priscilla Gates 1 2 3 4 , Haryana M Dhillon 5 , Mei Krishnasamy 2 3 , Carlene Wilson 6 7 8 , Karla Gough 2 9
  1. Department of Clinical Haematology, Austin Health, Heidelberg, Victoria, Australia
  2. Department of Nursing, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
  3. Academic Nursing Unit, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  4. Cognitive Neuroscience Lab, School of Psychology, Deakin University, Burwood, Victoria, Australia
  5. Faculty of Science, School of Psychology, Centre for Medical Psychology& Evidence-based Decision-Making, The University of Sydney, Sydney, New South Wales, Australia
  6. School of Psychology and Public Health, LaTrobe University, Melbourne, Victoria, Australia
  7. Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
  8. Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, VIC, Australia
  9. Department of Health Services Research, Peter MacCallum Cancer Center, Melbourne, Victoria, Australia

Aim

Cancer-related cognitive impairment is a recognised adverse consequence of cancer and its treatment but there is little research including patients with aggressive lymphoma. The aim of this study is to describe self-reported cognitive function and neuropsychological performance in a lymphoma population and compare their function and performance with healthy controls. We also examine the associations between patients’ neuropsychological performance, cognitive function and distress.

Method

Secondary analysis of data from a longitudinal feasibility study of 30 patients with newly diagnosed aggressive lymphoma, and a cohort study that included 72 healthy controls was undertaken. Patients completed self-report measures and neuropsychological tests before and 6-8 weeks after chemotherapy, including the PROMIS Anxiety 7a/Depression 8b and FACT-Cog; and the Trail Making Test, Hopkins Verbal Learning Test, and WAIS-R Digit Span. Healthy controls completed the FACT-Cog and neuropsychological tests at study enrolment and six months later. Mixed models were used to analyse FACT-Cog and neuropsychological test scores. Kendall’s Tau provided a measure of association between global deficit scores and scores from other measures.

Results

Patients and healthy controls were well matched on key demographic variables. Most differences between patients’ and healthy controls’ neuropsychological test scores were large-sized; the performance of patients was worse both before and after chemotherapy (most p<0.001). The same pattern of results was observed for the impact of perceived cognitive impairment on quality-of-life (both p<0.001), but not perceived cognitive impairment or abilities (all p>0.10). Associations between neuropsychological performance, self-reported cognitive function and distress were trivial to small-sized (all p>0.10).

Conclusion

For many patients with aggressive lymphoma, impaired neuropsychological test performance and the impact of perceived impairments on quality-of-life precede chemotherapy and are sustained 6-8 weeks after chemotherapy. Our data support the need for further longitudinal studies in this population to inform development of targeted interventions to address cognitive impairment.