Heart failure after allogeneic hematopoietic stem cell transplantation

Area of Science:

• Hematology
• Cardiology
• Oncology

Background:

• Heart failure (HF) post-allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a rare but serious complication.
• Understanding risk factors is crucial for early detection and management.

Purpose of the Study:

• To identify pre-transplant and transplant-related factors associated with HF development after allo-HSCT.
• To stratify risk for HF in patients undergoing allo-HSCT.

Main Methods:

• A nested case-control study analyzed 2455 patients undergoing allo-HSCT for hematologic malignancies (2000-2011).
• Cases with HF were matched with controls based on age, transplant year, and follow-up duration.

Main Results:

• Forty-two HF cases were identified, with a mean presentation time of 5 months post-HSCT.
• Increased pre-HSCT chemotherapy cycles (≥5) and ≥2 severe transplant-related complications were independently associated with higher HF risk (OR=3.5 and OR=3.6, respectively).
• Severe acute GVHD and hemorrhagic cystitis were more frequent in HF cases.

Conclusions:

• Patients with extensive pre-transplant chemotherapy and multiple severe transplant complications are at elevated risk for HF after allo-HSCT.
• Targeted surveillance and proactive management strategies are recommended for these high-risk patients.