Cardiovascular risk factors in hematopoietic cell transplantation survivors: role in development of subsequent cardiovascular disease

Abstract

Hematopoietic cell transplantation (HCT

Chronic disease burden and frailty in survivors of childhood HSCT: a report from the St. Jude Lifetime Cohort Study

“…These data extend information provided by previous studies completed in childhood HSCT survivors earlier in follow-up after transplant, or in combined cohorts of pediatric and adult HSCT recipients. For example, Bajwa et al reported dyslipidemia in 13% of 160 childhood HSCT survivors 7 years after transplant 19 ; Armenian et al, in a cohort of 1885 pediatric and adult HSCT survivors, reported 35.6% with hypertension, 16.8% with diabetes, and 43.7% with dyslipidemia 5 years posttransplant 20 ; and Chow et al, in a cohort of 2362 pediatric and adult HSCT survivors, reported 33.9% with dyslipidemia, 27.9% with hypertension, and 14.3% with diabetes 11 years posttransplant. 21 The prevalence of clinically ascertained frailty among adult survivors of childhood hematological malignancies treated with HSCT in this cohort was 7% compared with 1.6% among survivors treated with conventional therapy.…”

Caring for the long-term survivor after allogeneic stem cell transplantation

“…10 Allogeneic HCT recipients are at an increased risk for CVRFs; the 10-year cumulative incidence of hypertension, diabetes, and dyslipidemia is 37.7%, 18.1%, and 46.7%, respectively; the risk for multiple (Ն2) CVRFs approaches 40%. 2 Conditioning with total body irradiation (TBI) is associated with an increased risk of dyslipidemia and diabetes. 2,11 Corticosteroids and calcineurin inhibitors used to manage GVHD also increase the risk of CVRFs.…”

“…1 However, HCT survivors are at risk of developing long-term complications such as cardiopulmonary compromise, musculoskeletal disorders, endocrinopathies, and subsequent malignancies. [2][3][4][5] The risk of these complications is influenced by pre-HCT therapeutic exposures, transplantation-related conditioning, and posttransplantation management of GVHD. These complications have a direct impact on the morbidity and mortality experienced by HCT survivors.…”

Late effects in children who underwent hematopoietic stem cell transplantation (review)

“…В связи с чем од-ним из ведущих рисков у пациентов с гематологиче-скими, онкологическими и иными заболеваниями, требующими ХТ, а также ТГСК, является патология сердца, которая может встречаться у них в 13 раз чаще, чем у здоровых сиблингов [41]. Особенности строения тканей сердца и сосудов делают их крайне восприим-чивыми не только к факторам лечения, предшеству-ющим ТГСК (ХТ и ЛТ), но и повреждению во время трансплантации (кондиционирование, цитокиновые реакции, иммуноопосредованные повреждения).…”

“…и воздействия химиопрепаратов, наиболее значимые из которых -антрациклины (например, доксо-или даунорубицин), и тотального облучения тела (ТОТ) [41]. Определен-ное воздействие оказывают и высокие дозы цикло-фосфамида, в особенности при наличии иных пред-располагающих факторов (например, при системном склерозе) [43].…”