Neuropsychological Functioning in Pediatric Patients With Leukemia or Lymphoma Treated With CAR T‐Cell Therapy: A Retrospective Chart Review
Bibliographic record
Abstract
BACKGROUND: Chimeric antigen receptor (CAR) T-cell therapy has emerged as a treatment option for pediatric and young adult patients with relapsed or refractory acute lymphoblastic leukemia and non-Hodgkin's lymphoma. However, limited information is available regarding the neuropsychological sequelae associated with this treatment. PROCEDURE: This study utilized a multisite, retrospective chart review methodology to describe neuropsychological functioning of pediatric patients prior to and following CAR T-cell infusion. RESULTS: In the pre-infusion cohort (n = 26), 39% demonstrated weaknesses (characterized as > 1 SD below the normative mean) on at least one neuropsychological measure, most typically set-shifting, visual motor integration, sustained attention, phonemic fluency, graphomotor processing speed, auditory working memory, and nondominant fine motor functions. In the post-infusion cohort (n = 23), 33% demonstrated impairments (characterized as ≥ 1.5 SD below the normative mean) in full-scale intelligence quotient, graphomotor processing speed, visual-motor integration, and fine motor speeded dexterity. Weaknesses (> 1 SD below the normative mean) in sustained attention, narrative verbal memory, academic skills, verbal fluency, and visual memory were also evident in this cohort. In the pre-post-infusion cohort (n = 6), 83% demonstrated at least one neuropsychological score that declined across time; however, there was variability in the neuropsychological domains that changed. As a group, academic skills declined over time. CONCLUSIONS: While conclusions should be tempered given the heterogeneity of the patient population, these findings offer preliminary evidence for specific neuropsychological outcomes in pediatric patients treated with CAR T-cell therapy. Limitations and implications for future practice are discussed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".