Incidence and predictors of congestive heart failure after autologous hematopoietic cell transplantation

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

“…These finding are in agreement with other studies that report a high risk for CVD in HCT survivors with multiple CVRFs, regardless of HCT type. 15,16,38 However, the current study extends beyond previous observations by demonstrating that patients with pre-HCT cardiotoxic exposures are at a particularly high risk of CVD, suggesting that CVRFs may accelerate myocardial remodeling after cardiotoxic therapy (pre-HCT anthracyclines, chest radiation) 38,39 or exacerbate existing endothelial injury because of GVHD and/or radiation. 15,40 Information obtained from the current study may help set the stage for the development of more aggressive intervention strategies such as early screening and treatment of CVRFs in HCT survivors at highest risk of adverse cardiovascular outcomes.…”

Prediction of cardiovascular disease among hematopoietic cell transplantation survivors

“…Details regarding methodology of patient tracking and data collection have been reported previously. 10,12,13 Exposure and outcome definitions Information pertaining to lifetime anthracycline chemotherapy (drug, cumulative dose) and chest radiation, as well as high-dose chemotherapy and radiation were captured using an established protocol. Cumulative anthracycline dose was calculated using an established cardiotoxicity risk score; cumulative dose of each agent was multiplied by a number that reflects its cardiotoxicity relative to doxorubicin (doxorubicin 5 1, daunorubicin 5 0.83, epirubicin 5 0.67, idarubicin 5 5, mitoxantrone54).…”

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

“…BMT recipients are exposed to chemotherapy and/or radiation before BMT (for management of primary cancer), at BMT (for the transplant procedure), and after BMT (for graft-versushost disease [GVHD] management and/or relapse of primary cancer). The cumulative therapeutic exposures injure normal tissues, leading to premature onset of chronic health conditions such as subsequent neoplasms (SNs), [1][2][3] congestive heart failure (CHF), [4][5][6] coronary artery disease, 7 and musculoskeletal abnormalities. 8,9 In fact, the 15-year cumulative incidence of severe or life-threatening chronic health conditions exceeds 40%, 10,11 resulting in premature mortality [12][13][14][15][16][17] ( Figure 1).…”