ABSTRACT Objectives Neurocognitive changes in hematological malignancies (HM) and as a sequela of hematopoietic stem cell transplantation (HSCT) remain under‐recognized. These changes may substantially affect patients' quality of life. Therefore, this review systematically evaluated longitudinal neurocognitive changes in patients with HM undergoing HSCT. Methods Following PRISMA guidelines, PubMed, Scopus, and CINAHL were searched on October 30, 2025. Longitudinal studies assessing neurocognitive changes in patients with HM undergoing HSCT, with or without healthy controls, were included. Risk of bias was assessed using an adapted National Institutes of Health quality assessment tool for before–after studies. Effect sizes with 95% confidence intervals were calculated to quantify changes in neurocognitive performance. Results Nine of 2012 studies met the inclusion criteria, with overall moderate study quality. Improvements may occur post‐HSCT; however, allogeneic HSCT and myeloablative conditioning were main risk factors identified for persistent cognitive decline. In line with white matter damage, executive function and attention/processing speed impairments likely represent core deficits, which may affect other cognitive impairments. Post‐HSCT changes depend on task characteristics, cognitive load, and conditioning intensity. Conclusions Future research should emphasize regular neurocognitive assessment to guide cognitive rehabilitation, implement pre‐transplant cognitive rehabilitation strategies to mitigate post‐HSCT cognitive decline, and enhance treatment outcomes.
Yap et al. (Sun,) studied this question.