Cardiovascular Complications in Long-Term Survivors After Allogeneic Hematopoietic Stem Cell Transplantation

Cardiovascular diseases (CVD) are emerging late effects after allogeneic hematopoietic stem cell transplantation (allo-HSCT), leading to considerable morbidity and mortality. These late CVD are in most cases related to enhanced atherosclerosis, promoted by the early appearance after transplantation of cardiovascular risk factors. According to the data obtained from the general population it is very likely that early intervention on these cardiovascular risk factors might defer the appearance of late CVD. This review focuses on the published data of cardiovascular diseases after transplantation, the potential associated risk factors, and the postulated pathophysiological mechanisms. A suggested approach for early identification of patients at risk, optimal surveillance, and screening of the modifiable cardiovascular risk factors and the possible early interventions are also discussed here. Long-term survivors should be assessed lifelong after HSCT; all healthcare providers involved in the follow-up of these patients should be aware of premature health threatening of cardiovascular diseases after transplantation. Semin Hematol 49:25-34. (C) 2012 Elsevier Inc. All rights reserved.