Putative Mechanisms of Cognitive Dysfunction in Chemotherapy-Naïve Diffuse Large B-Cell Lymphoma: A Case Report and Review of the Literature

Abstract

Cognitive impairment is now recognized as a frequent consequence of treatments for cancers localized outside the central nervous system (CNS). In contrast, little attention has been given to the potentially deleterious cognitive effects from non-CNS cancers themselves. The present case study proposes that cognitive deficits occur in a subset of treatment-naïve patients with diffuse large B-cell lymphoma in whom no gross evidence of lymphoma-related CNS involvement is apparent. Evidence is presented from a case study and elaborate putative mechanisms centering on deleterious effects of B-cell-mediated inflammatory cytokine secretion on neurons. Moreover, this case study speculates that genetic variability involving apolipoprotein E or other factors may mediate cognitive variability among these patients.

Key words:

• apolipoprotein E
• B-lymphocytes
• cognition disorders
• cytokines
• lymphoma

Notes

Note. BNT = Boston Naming Test; CDT = Clock Drawing Test; COWA-FAS = Controlled Oral Word Association; HVLT-R = Hopkins Verbal Learning Test-Revised; MCST = Modified Wisconsin Card Sorting Test; MMSE = Mini-Mental State Examination; ROCFT = Rey-Osterrieth Complex Figure; SDMT = Symbol Digit Modalities Test (oral administration); WAIS-III = Wechsler Adult Intelligence Scale-Third Edition; WNL = within expected limits.

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