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Cardiac complications in patients who underwent to hematopoietic stem cell transplantation
Erman Ataş1, M Tezer Kutluk2, Canan Akyüz2
1Department of Pediatrics, Division of Pediatric Oncology, University of Health Sciences, Gulhane Faculty of Medicine, Ankara, Turkey.
Insights
Hematopoietic stem cell transplantation (HSCT) can lead to cardiac complications. This study found a 6.7% incidence of serious cardiac events post-HSCT, with early intervention potentially preventing mortality.
Area of Science:
- Cardiology
- Hematology
- Oncology
Background:
- Hematopoietic stem cell transplantation (HSCT) is a critical treatment for various hematologic and oncologic conditions.
- Despite advancements in supportive care, HSCT remains associated with significant risks, including cardiac complications.
- Understanding the frequency and impact of cardiac issues post-HSCT is crucial for improving patient outcomes.
Purpose of the Study:
- To determine the incidence of clinically significant cardiac complications in patients undergoing HSCT.
- To analyze the types of cardiac events observed after HSCT.
- To assess the relationship between cardiac complications and survival rates post-HSCT.
Main Methods:
- A retrospective analysis was conducted on 75 patients who underwent HSCT.
- Cardiac complications were identified through physical examination, electrocardiography, echocardiography, and cardiac monitoring.
- Data on patient demographics and clinical outcomes were collected and analyzed.
Main Results:
- The overall incidence of cardiac complications was 6.7% (5 out of 75 patients).
- Observed complications included pericardial effusion (3 patients), sinus bradycardia (2 patients), and ventricular tachycardia (1 patient).
- While mortality was higher in patients with cardiac complications (40% vs. 34%), this difference was not statistically significant (P = 0.82).
Conclusions:
- Several factors, including patient risk factors, infections, and treatment agents (anthracyclines, cyclophosphamide, irradiation, DMSO), may contribute to cardiac complications post-HSCT.
- Pericardial effusion was noted in all deceased patients with cardiac complications.
- Prompt recognition and intervention for cardiac complications are essential to prevent treatment-related mortality.
Aim Of Study:
Cardiac complications may be observed after hematopoietic stem cell transplantation (HSCT). Despite significant improvement in supportive care, HSCT may be associated with significant morbidity and mortality. In this study, the aim was to evaluate the frequency of clinically serious cardiac complications after HSCT in our patients.
Materials And Methods:
This is a retrospective study. Cardiac complications were analyzed in 75 patients undergone to HSCT with physical examination, electrocardiography, echocardiography, and cardiac monitorization.
Results:
The median age was 12 years (range 11-16) and M/F ratio was 2/3 = 0.66. There are five patients with six complications among the retrospective cohort of 75. These were pericardial effusion in three patients, and sinus bradycardia in two patients and ventricular tachycardia in one patient. The incidence of cardiac complications among 75 patients with HSCT was 6.7%. The mortality rates of patients with and without cardiac complication were 40% and 34%, and both of them with cardiac complication had pericardial effusion. However, the cardiac complication was not found statistically significant factor on survival ( P = 0.82).
Conclusion:
Poor risk factors of patients, myocarditis, pericarditis, and heart failure owing to cumulative doses of anthracycline, cyclophosphamide, cytomegalovirus infection or other infections, mediastinal irradiation, and cryopreserved stem cell product with dimethyl sulfoxide may be effective on the development of cardiac complications individually. Early intervention can prevent death related to this complication.
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