Cardiovascular disease in survivors of hematopoietic cell transplantation

Abstract

Hematopoietic cell transplantation (HCT) is increasingly offered as a curative option for many patients with hematologic malignancies. Improvements in HCT strategies and supportive care have resulted in a growing number of long-term survivors. However, these survivors are at increased risk of developing long-term debilitating chronic health conditions, including premature cardiovascular disease. These complications are more common than in the general population, and there are well-described associations between therapeutic exposures, traditional cardiovascular risk factors and subsequent cardiovascular disease risk. We present here an overview of the current state of knowledge regarding pathogenesis and risk factors for some of the more commonly occurring cardiovascular complications following HCT, highlighting existing surveillance recommendations and future directions for research to minimize cardiovascular morbidity in these survivors.

How I monitor long-term and late effects after blood or marrow transplantation

“…21 BMT survivors have a fourfold increased risk of developing CVD when compared with the general population. 22 Median age at first cardiovascular event is 53 years of age, 7 lower than that observed in the general population (67 years of age).…”

Prediction of cardiovascular disease among hematopoietic cell transplantation survivors

“…7 However, examining cardiovascular-related mortality alone underestimates the true burden of cardiovascular morbidity. HCT survivors have a fourfold higher risk of developing cardiovascular disease (CVD) compared with the general population, 7,8 adding to the already high burden of chronic healthrelated conditions in these survivors. 9 Among HCT survivors, median age at first cardiovascular event such as myocardial infarction is 53 years (range, 35-66 years), 10 much lower than would be expected in the general population (67 years).…”

Critically ill allogeneic hematopoietic stem cell transplantation patients in the intensive care unit: reappraisal of actual prognosis

“…[52][53][54] Noninfectious causes of organ failure are usually diagnosed after exclusion of infections. They are mainly represented by cardiac edema, treatment toxicity, 39,40,[54][55][56][57][58][59][60][61][62][63] hemorrhages, GvHD, long-term allo-HSCT complications, 60,64 comorbidity decompensation and relapse. Several post-allograft complications can occur, but they do not all occur at any particular stage of the disease.…”