Post-chemotherapy cognitive impairment in patients with B-cell non-Hodgkin lymphoma: a first comprehensive approach to determine cognitive impairments after treatment with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone or rituximab and bendamustine

Abstract

To assess the effects of chemoimmunotherapy on post-chemotherapy cognitive impairments (PCCI) in patients with B-cell non-Hodgkin lymphoma (NHL), we used objective and subjective measures of cognitive functions in combination with serum parameters and neuroelectric recordings. Self-perceived status of cognition, fatigue and emotional functioning were reduced in patients (n = 30) compared to healthy controls (n = 10). Cognitive performance was impaired in patients with NHL compared to controls and a norm sample (n = 1179). PCCI was more severe in patients treated with rituximab and bendamustine (BR) than in patients who received R in combination with CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) polychemotherapy (R-CHOP). Individual alpha peak frequency and serum brain-derived neurotrophic factor (BDNF) levels in patients with NHL correlated with accuracy in the objective cognition test. Higher serum interleukin-6 (IL-6) concentrations were associated with higher fatigue levels. Patients with NHL and especially those who were treated with BR were affected by PCCI. BDNF and IL-6 might be involved in the pathogenesis of PCCI and fatigue.

Keywords::

• Chemobrain
• lymphoma
• EEG
• fatigue
• cognition
• cytokines

Acknowledgements

The authors would like to thank Dr. Pauline Schuhmacher and Mrs. Muriel Freudenberger for editorial support. Dr. Schuhmacher is supported by the German Federal Ministry of Research and Education (BMBF grant 01KN1106). Mrs. Freudenberger is supported by the Cologne Excellence Cluster for Cellular Stress Responses in Aging-Associated Diseases (CECAD) (DFG EXC 229). Furthermore, the authors would like to thank Mrs. Anke Schmitz and Mrs. Anika Voss for their technical support.

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