Clinical prevalence and outcome of cardiovascular events in the first 100 days postallogeneic hematopoietic stem cell transplant

• Published in: European journal of haematology 2021-01, Vol.106 (1), p.32-39
• Main Authors: Alblooshi, Rehab, Kanfar, Solaf, Lord, Bridgette, Atenafu, Eshetu G., Michelis, Fotios V., Pasic, Ivan, Gerbitz, Armin, Al‐Shaibani, Zeyad, Viswabandya, Auro, Kim, Dennis (Dong Hwan), Lam, Wilson, Law, Arjun, Mattsson, Jonas, Kumar, Rajat, Lipton, Jeffrey H.
• Format: Article
• Language: English
• Subjects: allogeneic hematopoietic stem cell transplant; Angina; Angina pectoris; Anthracycline; Arrhythmia; Cardiomyopathy; Cardiovascular diseases; cardiovascular events; CV events; Drug dosages; Heart surgery; hematopoietic stem cell transplant; Hematopoietic stem cells; HSCT; Medicin och hälsovetenskap; Risk factors; Stem cell transplantation; Stem cells; Toxicity
• ISSN: 0902-4441; 1600-0609; 1600-0609
• DOI: 10.1111/ejh.13482

Introduction Recent advances in allogeneic hematopoietic stem cell transplant (HSCT) have allowed us to offer HSCT to older, advanced disease patients with more co‐morbidities. Cardiovascular toxicity post‐transplant is a major concern due to the increased risk of mortality. Few studies have examined the prevalence of CV events including CAD (MI, angina, PCI, CABG, CHF, arrhythmias), HTN, stroke/TIA, and death in the first 100 days post‐transplant. Patients We assessed the impact of pretransplant MUGA results in predicting postallogeneic HSCT CV events and overall survival in the first 100 days, and whether or not transient anthracycline‐induced cardiomyopathy or cumulative anthracycline dose affected overall survival. This retrospective, cohort study included 665 patients with a median age of 52 years who underwent HSCT from 2009 to 2015. Results The most frequent CV event in the first 100 days post‐HSCT was arrhythmia seen in 2.9% of patients followed up by CHF (12.3%), MI (9%), and angina (8%). Two patients had PCI, and both survived the first 100 days. Cardiovascular risk factors predict for a poor MUGA scan but not survival. Higher dose anthracycline pretransplant predicted for a poor outcome. Conclusion A history of CV disease, MI, or CAD was the most important predictive of CV events, P‐value = .00002. 88.6% survived the first 100 days. Patients with an EF  60% (OR = 5.3, 95% CI [1.6‐18.1], P = .0219). Cumulative anthracycline dose did not have a significant impact on overall survival.