Cardiac Manifestations of Graft-versus-Host Disease

Rackley, Cynthia; Schultz, Kirk R.; Goldman, Frederick D.; Chan, Ka Wah; Serrano, Amy; Hulse, J.E.; Gilman, Andrew L.

doi:10.1016/j.bbmt.2005.07.002

Cited by 72 publications

(50 citation statements)

References 24 publications

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“…There are some reports of cardiac dysfunction during GVHD but these are just case series. [21][22][23][24] However, a larger, retrospective cohort study showed no statistically significant difference in the incidence of congestive heart failure among patients with acute GVHD, those with a history of chronic GVHD and Cardiac dysfunction in the chronic phase of HCT M Nishimoto et al those with active GVHD. 25 Uderzo et al 13 report similar findings in childhood HCT.…”

Section: Discussionmentioning

confidence: 99%

Risk factors affecting cardiac left-ventricular hypertrophy and systolic and diastolic function in the chronic phase of allogeneic hematopoietic cell transplantation

Nishimoto

Nakamae

Koh

et al. 2012

Bone Marrow Transplant

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Chronic impairment of cardiac function can be an important health risk and impair the quality of life, and may even be life-threatening for long-term survivors of allogeneic hematopoietic cell transplantation (HCT). However, risk factors for and/or the underlying mechanism of cardiac dysfunction in the chronic phase of HCT are still not fully understood. We retrospectively investigated factors affecting cardiac function and left-ventricular hypertrophy (LVH) in the chronic phase of HCT. Sixty-three recipients who survived for 41 year after receiving HCT were evaluated using echocardiography. Based on simple linear regression models, high-dose TBI-based conditioning was significantly associated with a decrease in left-ventricular ejection fraction and the early peak flow velocity/atrial peak flow velocity ratio, following HCT (coefficient ¼ À 5.550, P ¼ 0.02 and coefficient ¼ À 0.268, P ¼ 0.02, respectively). These associations remained significant with the use of multiple linear regression models. Additionally, the serum ferritin (s-ferritin) level before HCT was found to be a significant risk factor for LVH on multivariable logistic analysis (P ¼ 0.03). In conclusion, our study demonstrated that a myeloablative regimen, especially one that involved high-dose TBI, impaired cardiac function, and that a high s-ferritin level might be associated with the development of LVH in the chronic phase of HCT.

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Section: Discussionmentioning

confidence: 99%

Risk factors affecting cardiac left-ventricular hypertrophy and systolic and diastolic function in the chronic phase of allogeneic hematopoietic cell transplantation

Nishimoto

Nakamae

Koh

et al. 2012

Bone Marrow Transplant

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Section: Cardiovascular Disease After Hematopoietic Cell Transplantatmentioning

confidence: 99%

“…Cardiac side effects of chronic GVHD, while rare, likely occur as a result of direct organ lymphocytic infiltration. 36 Increased levels of circulating tumor necrosis factor α may impair mus- cle electrical activity and compromise myocardial contractility. 36,37 Furthermore, increasd amounts of inflammatory markers, such as tumor necrosis factor-α and interleukin-6, could perpetuate endothelial injury, contributing to premature arterial events in long-term survivors after allogeneic HCT.…”

mentioning

confidence: 99%

Cardiovascular disease after hematopoietic cell transplantation - lessons learned

Armenian¹,

Bhatia²

2008

Haematologica

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H ematopoietic cell transplantation (HCT) has now become the treatment of choice for a large number of malignant and non-malignant diseases.1 It is quite clear that unless effective targeted therapy becomes available, HCT will continue to be offered as a curative therapeutic modality to patients diagnosed with a variety of malignant and non-malignant disorders. Among those who survive the first 2 years, nearly 80% of allogeneic HCT recipients 2,3 and 70% of autologous HCT recipients 4 are expected to become long-term survivors, with an attendant growth in such survivors. Due to improvements in survival rate, major issues for patients undergoing HCT have expanded to include the care and management of survivors, prevention of adverse outcomes, and maintenance of a good health-related quality of life. Some of the well-described complications in this population include subsequent malignancies, cataracts, pulmonary complications, endocrine dysfunction, osteonecrosis, chronic kidney disease, and impairment in functional status due to persistent, chronic graft-versus-host disease (GVHD).5-7 Details regarding cardiovascular dysfunction after HCT are now emerging. [8][9][10] In this issue of the journal, Tichelli et al. publish the results of their retrospective study designed to describe the magnitude of risk of and associated risk factors for the development of arterial events after allogeneic HCT. 10 The events of interest include coronary artery disease, cerebrovascular disease and peripheral artery disease. They report that the cumulative incidence of arterial events at 15 years is 6%, and identify older age at the time of HCT and presence of pre-established cardiovascular risk factors (diabetes, obesity, dyslipidemia, arterial hypertension) as being associated with an increased risk of these outcomes.In a recent study, we used a nested case-control study design to examine the independent role of pre-HCT exposure to therapeutic agents, transplant-related conditioning and co-morbidities in the development of congestive heart failure (CHF) after HCT. 8,9 We identified pre-HCT exposure to anthracyclines and the presence of post-HCT co-morbidities as being associated with delayed CHF after HCT.The best-described therapy-related late cardiac complications include valvular dysfunction, conduction abnormalities, pericarditis, and cardiomyopathy. [11][12][13] Arterial complications can occur as a result of damage to the entire vascular system and include coronary artery disease, cerebrovascular disease, and peripheral artery disease.14,15 While the latency period for many of these diseases can be short, survivors often do not have clinical evidence of disease until several years following HCT.14-16 As with most other complications observed after HCT, cardiovascular complications following HCT are due, in part, to the treatment prior to, during, and following HCT.Age at therapeutic exposure, gender, and past medical history are important considerations when identifying the potential risk of long-term cardiovascular disease. ...

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“…Риск смерти от сердечно-сосудистых осложнений у больных после алло-ТГСК в 2,3 раза выше, чем в общей популяции взрослых [3]. Кроме того, в литературе описано не-сколько случаев фатального развития инсульта и ише-мической болезни сердца у молодых пациентов после алло-ТГСК [4].…”

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Dyslipidemia and Metabolic Syndrome in Children and Teenagers After the Allogeneic Hematopoietic Stem Cell Transplantation

Станчева¹,

Семенова²,

Боровкова³

et al. 2015

Ross. ž. det. gematol. onkol.

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Cardiac Manifestations of Graft-versus-Host Disease

Cited by 72 publications

References 24 publications

Risk factors affecting cardiac left-ventricular hypertrophy and systolic and diastolic function in the chronic phase of allogeneic hematopoietic cell transplantation

Risk factors affecting cardiac left-ventricular hypertrophy and systolic and diastolic function in the chronic phase of allogeneic hematopoietic cell transplantation

Cardiovascular disease after hematopoietic cell transplantation - lessons learned

Dyslipidemia and Metabolic Syndrome in Children and Teenagers After the Allogeneic Hematopoietic Stem Cell Transplantation

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