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Constrictive pericarditis post allogeneic bone marrow transplant for Philadelphia-positive acute lymphoblastic
J Cavet1, A Lennard, A Gascoigne
1Department of Haematology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
Bone Marrow Transplantation
|March 14, 2000
Summary
Severe pericarditis can occur after allogeneic bone marrow transplantation (BMT). This condition, constrictive pericarditis, may lead to persistent cardiac issues even after surgical intervention.
Area of Science:
- Hematology
- Cardiology
- Oncology
Background:
- Allogeneic bone marrow transplantation (BMT) is a crucial treatment for hematologic malignancies.
- Conditioning regimens often include chemotherapy and total body irradiation.
- Potential long-term complications require ongoing investigation.
Observation:
- Two cases of severe constrictive pericarditis are presented following BMT for Philadelphia-chromosome positive acute lymphoblastic leukemia (ALL).
- The conditioning regimen involved total body irradiation and melphalan.
- Patients underwent pericardectomy with initial improvement in ventricular filling.
Findings:
- Constrictive pericarditis, previously undescribed after BMT, was diagnosed.
- Persistent right-sided cardiac failure was noted, attributed to restrictive cardiomyopathy.
- The findings suggest a link between BMT conditioning and cardiac complications.
Implications:
- Constrictive pericarditis and restrictive cardiomyopathy should be considered in patients with late-onset breathlessness or edema post-BMT.
- This highlights the need for cardiac surveillance in BMT survivors.
- Understanding these complications can improve long-term patient management.