Conclusion
Our study found that pediatric HCT survivors surveyed at a median of 27 years post-transplant reported higher frequencies of impairments in the domains of emotional regulation, task efficiency, memory, and organization but similar cognitive quality of life compared with the general population. Subsets of survivors with certain neurologic co-morbidities were at higher risk for worse neurocognitive outcomes, which may influence monitoring and counseling for post-HCT survivorship care. Sleep intervention and early referral for educational and rehabilitation services may offer possible avenues to mitigate HCT-related treatment effects on later life achievements.