Cardiac systolic function before and after hematopoietic stem cell transplantation

Area of Science:

• Cardiology
• Hematology
• Oncology

Background:

• Hematopoietic stem cell transplantation (HSCT) is a critical treatment for various hematologic malignancies and other diseases.
• Potential cardiotoxicity from prior treatments (e.g., anthracyclines) and the transplantation procedure itself necessitates evaluation of cardiac function post-HSCT.
• Left ventricular ejection fraction (LVEF) is a key indicator of cardiac systolic function.

Purpose of the Study:

• To assess the impact of HSCT on cardiac systolic function.
• To evaluate changes in LVEF before and after HSCT in a diverse patient cohort.
• To identify any patient subgroups or pre-transplant factors associated with changes in cardiac function.

Main Methods:

• Prospective measurement of LVEF using radioventriculography (RVG) in 148 patients before and after HSCT.
• Subgroup analysis based on transplant type (allogeneic vs. autologous) and primary diagnosis (CML, AML, ALL, multiple myeloma, breast cancer).
• Correlation analysis with prior anthracycline exposure and long-term clinical follow-up for heart failure.

Main Results:

• Mean LVEF remained stable post-HSCT (60.2% pre vs. 61.1% post) across the entire cohort.
• No significant changes in LVEF were observed in any diagnostic subgroup or between allogeneic and autologous recipients.
• Patients with prior anthracycline exposure had lower pre-transplant LVEF but did not experience a greater decline post-HSCT.

Conclusions:

• HSCT procedure does not appear to adversely affect myocardial systolic function in the 1-7 month period following transplantation.
• Cardiac function remains stable despite prior treatments like anthracyclines in patients undergoing HSCT.
• Long-term follow-up showed no clinical heart failure development in the studied patient population.