Early-onset cardiac dysfunction following allogeneic haematopoietic stem cell transplantation

被引:6
作者
Moriyama, Shohei [1 ]
Fukata, Mitsuhiro [1 ]
Hieda, Michinari [1 ]
Yokoyama, Taku [1 ]
Yoshimoto, Goichi [1 ]
Kusaba, Hitoshi [1 ]
Nakashima, Yasuhiro [2 ]
Miyamoto, Toshihiro [3 ]
Maruyama, Toru [4 ]
Akashi, Koichi [1 ]
机构
[1] Kyushu Univ Hosp, Dept Haematol Oncol & Cardiovasc Med, Fukuoka, Japan
[2] Kyushu Univ, Grad Sch Med Sci, Dept Med & Bioregulatory Sci, Fukuoka, Japan
[3] Kanazawa Univ, Fac Med, Inst Med Pharmaceut & Hlth Sci, Dept Hematol, Kanazawa, Ishikawa, Japan
[4] Kyushu Univ, Ctr Hlth Sci & Counseling, Fukuoka, Japan
来源
OPEN HEART | 2022年 / 9卷 / 01期
关键词
cardiomyopathies; heart failure; systolic; risk factors; BONE-MARROW-TRANSPLANTATION; REGULATORY T-CELLS; AMERICAN SOCIETY; PREDICTIVE-VALUE; CANCER-THERAPY; HEART-FAILURE; COMPLICATIONS; CARDIOTOXICITY; PREVENTION; MORTALITY;
D O I
10.1136/openhrt-2022-002007
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective Heart failure following allogeneic haematopoietic stem cell transplantation (allo-HSCT) is a serious complication that requires early detection; however, the clinical implications of early-onset cancer therapy-related cardiac dysfunction (CTRCD) following allo-HSCT remain unclear. We investigated the determinants and prognostic impact of early-onset CTRCD in allo-HSCT recipients. Methods The records of 136 patients with haematological malignancies who underwent allo-HSCT at our institute were retrospectively reviewed. Early-onset CTRCD was defined as a decrease in left ventricular ejection fraction (LVEF) of >= 10% and an LVEF of <= 53% within 100 days after HSCT. Results Early-onset CTRCD was diagnosed in 23 out of 136 included patients (17%), and the median duration from HSCT to CTRCD diagnosis was 24 (9-35) days. Patients were followed up for 347 (132-1268) days. In multivariate logistic regression analysis, cumulative doxorubicin dosage (each 10 mg/m(2)) and severity of acute graft-versus-host disease (GVHD/grade) were independent indicators of early-onset CTRCD (OR (95% CI) 1.04 (1.00 to 1.07); p=0.032; OR (95% CI) 1.87 (1.19 to 2.95), p=0.004, respectively). The overall and primary disease death rates were significantly higher in allo-HSCT recipients with early-onset CTRCD than in those without early-onset CTRCD (HR (95% CI) 1.98 (1.11 to 3.52), p=0.016; HR (95% CI) 2.96 (1.40 to 6.29), p=0.005, respectively), independent of primary disease type, remission status and transplantation type. Conclusions Severe acute GVHD and higher cumulative anthracycline are two significant determinants of early-onset CTRCD. Early-onset CTRCD following allo-HSCT regulates survival in patients with haematological malignancies.
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页数:8
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