Neuroimaging and Neurocognitive Outcomes in Older Patients with Multiple Myeloma Treated with Chemotherapy and Autologous Stem Cell Transplantation.
Denise D CorreaBehroze A VachhaRaymond E BaserAdrian KochPhillip WongSuril GohelSergio GiraltJames C RootPublished in: Cancers (2023)
There is a paucity of research on treatment-related neurotoxicity in older adults with multiple myeloma (MM) treated with high-dose chemotherapy (HDC) and autologous SCT (HDC/ASCT), despite the increasing use of this regimen. We examined resting state functional connectivity (RSFC), gray matter (GM) volume, neurocognitive function (NF), and proinflammatory cytokines (PCy) in older patients with MM pre- and post-HDC/ASCT. Eighteen patients underwent MRI, NF tests, and serum PCy measurements prior to HDC/ASCT, and fifteen patients completed a follow up five-months post-HDC/ASCT. There were significant decreases in RSFC post-HDC/ASCT in (1) the central executive network (CEN) involving the left dorsolateral prefrontal cortex and right posterior parietal cortex ( p = 0.022) and (2) the CEN involving the right posterior parietal cortex and the salience network involving the right dorsal anterior cingulate cortex ( p = 0.029). There were no significant changes in GM or NF, except for improvements in attention (Digit Span Backward, p = 0.03). There were significant increases in several PCy post-HDC/ASCT ( p ≤ 0.05). In conclusion, RSFC decreased in frontal, parietal, and cingulate cortices post-HDC/ASCT, NF was relatively stable, and several PCy increased. These findings are congruent with other studies in cancer patients and provide supporting evidence for the vulnerability of frontoparietal regions to chemotherapy's adverse effects.
Keyphrases
- functional connectivity
- resting state
- working memory
- high dose
- stem cell transplantation
- signaling pathway
- prefrontal cortex
- multiple myeloma
- newly diagnosed
- end stage renal disease
- lps induced
- ejection fraction
- oxidative stress
- pi k akt
- physical activity
- cell therapy
- prognostic factors
- climate change
- magnetic resonance imaging
- spinal cord
- nuclear factor
- locally advanced
- low dose
- stem cells
- adipose tissue
- skeletal muscle
- metabolic syndrome
- peritoneal dialysis
- patient reported
- diffusion weighted imaging
- patient reported outcomes
- community dwelling
- replacement therapy