Cognitive function in patients with chronic lymphocytic leukemia: a cross-sectional study examining effects of disease and treatment

Abstract

Cancer-related cognitive impairment (CRCI) has not been objectively assessed in chronic lymphocytic leukemia (CLL). It is currently unclear how much of CRCI is attributable to disease, treatment, or both. We used CLL as a novel model to study the differential roles of disease and treatment in CRCI. One hundred and fifty CLL patients (100 treatment-naïve and 50 chemotherapy-treated) including 84 patients with higher-risk of CLL progression completed objective neuropsychological tests. Sociodemographic-adjusted linear regression models examined cognitive outcomes in relation to risk and treatment. Higher-risk patients recalled two fewer words on a memory task (β = −1.8, 95%CI –3.3,−0.3) and took 15 s longer on an executive function task (β = 15.4, 95%CI 3.1, 27.6) than lower-risk patients, independent of treatment. Treated patients reported greater cognitive difficulties than treatment-naive patients (β = −6.1, 95%CI –10.1, −2.2) but did not perform worse on objective measures. Higher-risk patients experienced impairments in executive function and memory suggesting that disease biology contributes to CRCI independent of treatment.

Keywords:

• Chronic lymphocytic leukemia
• cognitive impairment
• chemotherapy
• treatment naïve

Acknowledgements

We would like to thank all of the patients who participated in our study. We would also like to thank members of the Cancer Control Psychoneuroimmunology Laboratory including Kassandra Doyle and Sara Alberti, and Sharon Lewinski, and Rina Yarosh for assisting with data collection.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the National Cancer Institute at the National Institutes of Health under grant number [F99CA222742] (to A.M.W.); under grant number [DP2CA195765 and K07CA168886] (to M.C.J.); and by the Michael Napoleone Foundation (to A.M.W.); and the Cadregari Endowment Fund (to C.S.Z.).