Heart failure after allogeneic hematopoietic stem cell transplantation.

Abstract

BACKGROUND:

Heart failure (HF) occurring after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is rare but severe. We examine the role of pre-HSCT therapeutic exposures, conditioning regimens, pre-HSCT comorbidities, severe transplant-related complications, and post-HSCT cardiovascular risk factors in the development of heart failure after allo-HSCT.

METHODS:

A nested case-control study was designed. Cases with HF and controls matched for age, year of allo-HSCT, and length of follow-up were identified from a cohort of 2455 patients who underwent allo-HSCT between 2000 and 2011 for hematologic malignancies.

RESULTS:

Forty-two patients suffered from HF; mean age at presentation was 35 years (± 14 years) and mean time to presentation was 5 months (± 9 months) post-HSCT. The number of pre-HSCT cycles of chemotherapy was significantly greater (7 vs. 5 courses, P=0.023). Cases were significantly more likely to have severe acute GVHD (≥ grade III), hemorrhagic cystitis (≥ grade 2), and multiple severe transplant-related complications compared with controls (42.9% vs. 20.4%, P=0.008). Multivariate analysis revealed that pre-HSCT cycles of chemotherapy of ≥ 5 courses (OR=3.5, P=0.003) and two or more severe transplant-related complications (OR=3.6, P=0.003) were independently associated with HF.

CONCLUSIONS:

These results identify the individuals who are at higher risk of developing HF after allo-HSCT. We should pay more attention to these patients and more active management would be reasonable.

• Authors: Xiao-Dong Mo, Lan-Ping Xu, Dai-Hong Liu, Xiao-Hui Zhang, Huan Chen, Yu-Hong Chen, Wei Han, Yu Wang, Feng-Rong Wang, Jing-Zhi Wang, Ting Zhao, Chen-Hua Yan, Yu-Qian Sun, Kai-Yan Liu, Xiao-Jun Huang
• Journal: International journal of cardiology (Int J Cardiol) Vol. 167 Issue 6 Pg. 2502-6 (Sep 10 2013) ISSN: 1874-1754 [Electronic] Netherlands
• PMID: 22727962 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Topics

• Adult
• Case-Control Studies
• Cohort Studies
• Female
• Follow-Up Studies
• Graft vs Host Disease (diagnosis, epidemiology)
• Heart Failure (diagnosis, epidemiology)
• Hematopoietic Stem Cell Transplantation (adverse effects, trends)
• Humans
• Male
• Middle Aged
• Postoperative Complications (diagnosis, epidemiology)
• Transplantation, Homologous
• Treatment Outcome
• Young Adult