PSYCHOLOGICAL EFFECTS OF BONE-MARROW TRANSPLANTATION ON CHILDREN AND ADOLESCENTS - PRELIMINARY-REPORT OF A LONGITUDINAL-STUDY

The number of pediatric bone marrow transplantation (BMT) survivors is growing rapidly, yet little is known about the long-term neuropsychol ogic and psychosocial sequelae of this procedure, Using a prospective, longitudinal design, 64 pediatric patients undergoing BMT were evalua ted with standardized measures of global intelligence, academic achiev ement and selected tests of neuropsychologic function, In addition, ad justment was assessed with parent and patient report measures of socia l competence, behavior problems and self-esteem, patients were evaluat ed prior to admission for BMT, and again in the period 6-12 months aft er BMT, Longitudinal findings are reported on an initial cohort of 25 survivors, Cognitive and neuropsychologic function remained stable dur ing the study period, The few significant changes from baseline which were observed were in the direction of improvement, and may be attribu ted to practice effects, In contrast, declines were observed in patien t social competence, self-esteem and general emotional well-being, BMT conditioning regimens appear not to be associated with significant ne uropsychologic impairment in the first year after transplant, However, a longer period of follow-up is necessary before neuropsychologic lat e-effects can be ruled out, The first year after BMT is characterized by significant psychosocial difficulties for survivors, Adjustment iss ues may provide a more salient focus of study during this time frame.