Rapid cardiovascular aging following allogeneic hematopoietic cell transplantation for hematological malignancy

Area of Science:

• Cardiology
• Hematology
• Oncology

Background:

• Allogeneic hematopoietic cell transplantation (allo-HCT) is a curative option for hematological malignancies.
• Long-term survivors of allo-HCT face increased cardiovascular morbidity and mortality.
• The short-term cardiovascular impact of allo-HCT remains incompletely understood.

Purpose of the Study:

• To evaluate the short-term (3-month) cardiovascular effects of allo-HCT.
• To compare cardiovascular function in allo-HCT patients versus an age-matched control group.

Main Methods:

• Prospective study involving 17 hematological cancer patients undergoing allo-HCT and 12 age-matched controls.
• Cardiopulmonary exercise testing to measure peak oxygen uptake (VO2peak).
• Exercise cardiac MRI, echocardiography, DXA, BP assessment, and hemoglobin sampling to assess cardiac and non-cardiac factors.

Main Results:

• Allo-HCT patients showed significant reductions in VO2peak (26%), bodyweight-indexed VO2peak (24%), and cardiac reserve (26%) after 3 months.
• Lean mass also decreased by 6% in the allo-HCT group.
• No significant changes in VO2peak or cardiac reserve were observed in the control group.

Conclusions:

• Allo-HCT leads to rapid and severe impairment of VO2peak, reflecting both central and peripheral cardiovascular dysfunction.
• These findings suggest that allo-HCT accelerates cardiovascular aging.
• Urgent implementation of preventive cardiovascular interventions is recommended for patients undergoing allo-HCT.