Abstract Background Autologous hematopoietic stem cell transplantation (AHSCT) is increasingly utilized for hematologic malignancies; however, its psychiatric and cognitive impacts remain underexplored. This study assessed psychiatric disorders and cognitive changes pre- and post-transplantation in adult patients undergoing AHSCT. Patients and methods This retrospective study included 55 patients aged 18–65 years, treated between 2016 and 2022 at Tanta University Bone Marrow Transplantation Unit. Psychiatric assessments using the Structured Clinical Interview for diagnostic and statistical manual of mental disorder (DSM-IV) k2Axis I Disorders (SCID-I) and cognitive assessments using the Trail Making Test and Montreal Cognitive Assessment were conducted at pre-conditioning, one day postinfusion, and three months post-transplant. Results Cognitive and psychiatric functions fluctuated significantly during transplantation ( P <0.001), with the greatest impairments noted during the neutropenic phase. Hodgkin lymphoma patients demonstrated significantly poorer cognitive outcomes compared with multiple myeloma patients ( P <0.001). Higher numbers of prior regimens, greater cluster of differentiation34⁺ cell doses, delayed engraftment, and transplant-related complications correlated with worsened cognitive performance. Despite these fluctuations, all patients achieved complete remission by day 100 post-transplant. Conclusions AHSCT is associated with dynamic psychiatric and cognitive fluctuations, particularly during the neutropenic phase. Disease type and transplant-related factors significantly influence neurocognitive outcomes. Routine psychiatric and cognitive monitoring should be integrated into transplant protocols to identify at-risk patients and guide early interventions.
Elsaied et al. (Wed,) studied this question.