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Pericarditis in Patients With Chronic Graft-vs-Host Disease
E Karakulska-Prystupiuk1, G Basak1, J Dwilewicz-Trojaczek1
1Department of Hematology, Oncology, and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.
Transplantation Proceedings
|September 5, 2018
Summary
Late pericarditis can affect up to 5% of allogeneic hematopoietic stem cell transplant survivors, particularly those with chronic graft-vs-host disease (cGVHD). Early diagnosis via NT-proBNP testing and echocardiography is key for favorable outcomes.
Area of Science:
- Hematology
- Cardiology
- Transplantation Medicine
Background:
- Pericarditis complications post-allogeneic bone marrow transplantation are rarely documented.
- Limited data exist on the incidence and risk of pericarditis following allogeneic hematopoietic cell transplantation (HCT).
Purpose of the Study:
- To determine the frequency of exudative pericarditis in allogeneic HCT recipients with chronic graft-vs-host disease (cGVHD).
Main Methods:
- Retrospective analysis of 105 HCT patients (2010-2016).
- Focused on 50 patients with cGVHD, including 24 with moderate/severe disease.
- Evaluated cardiology parameters: ECG, echocardiography, NT-proBNP, and clinical follow-up.
Main Results:
- Pericarditis diagnosed in 6 patients (5.7%) 4-23 months post-HCT.
- All affected patients had severe cGVHD and elevated NT-proBNP with heart insufficiency.
- Treatment required intensified immunosuppression beyond initial glucocorticosteroids.
Conclusions:
- Late pericarditis occurs in up to 5% of allogeneic HCT survivors, mainly those with moderate/severe cGVHD.
- Systematic NT-proBNP testing and echocardiography aid early diagnosis.
- While requiring escalated immunosuppression, pericarditis generally has a favorable prognosis.
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