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Late cardiovascular morbidity and mortality following pediatric allogeneic hematopoietic cell transplantation.

Abstract：

:We analyzed late cardiovascular outcomes of 661 patients who survived at least 2 years from hematopoietic cell transplantation for childhood hematologic malignancy between 1995 and 2008. Center for International Blood and Marrow Transplant Research data was supplemented with surveys focused on cardiotoxicity and potential risk factors. The median duration of follow-up was 97 months (range 24-230). 4.2% of survivors experienced at least one of the primary outcomes including coronary artery disease (0.2%), cerebrovascular accident (0.6%), cardiomyopathy (3%), and cardiac-related death (0.5%). Patients who received anthracycline chemotherapy (HR 4.67, p = 0.036) or cranial or chest radiation (HR 5.58, p < 0.0001; HR 2.18, p = 0.0087) were at increased risk for developing one of the primary outcomes. Dyslipidemia was diagnosed in 18% of survivors. Pre-transplant anthracycline (HR 1.74, p < 0.0001) and chest radiation (HR 1.34, p = 0.0371) were risk factors for dyslipidemia. Overweight/obese body mass status was present in 63% of patients at baseline, 65% at 2 years, and 52% at most recent evaluation. Diabetes was diagnosed in 7% of subjects. In conclusion, severe cardiovascular complications were infrequently reported. The incidence of risk factors including obesity and dyslipidemia were significant and will likely increase the risk of cardiovascular disease over time in transplant survivors.

journal_name

Bone Marrow Transplant

journal_title

Bone marrow transplantation

authors

Duncan CN,Brazauskas R,Huang J,Shaw BE,Majhail NS,Savani BN,Flowers MED,Battiwalla M,Beebe K,Dietz AC,Dvorak CC,Giller R,Jacobsohn DA,Kletzel M,Martin PL,Nemecek ER,Nuechterlein B,Talano JA,Pulsipher MA,Baker KS

doi

10.1038/s41409-018-0155-z

subject

Has Abstract

pub_date

2018-10-01 00:00:00

pages

1278-1287

issue

10

eissn

0268-3369

issn

1476-5365

pii

10.1038/s41409-018-0155-z

journal_volume

53

pub_type

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