Late cardiovascular morbidity and mortality following pediatric allogeneic hematopoietic cell transplantation.
Submitted by Eneida R Nemecek on
Title | Late cardiovascular morbidity and mortality following pediatric allogeneic hematopoietic cell transplantation. |
Publication Type | Journal Article |
Year of Publication | 2018 |
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, J-A, Pulsipher, MA, K Baker, S |
Journal | Bone Marrow Transplant |
Volume | 53 |
Issue | 10 |
Pagination | 1278-1287 |
Date Published | 2018 Oct |
ISSN | 1476-5365 |
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. |
DOI | 10.1038/s41409-018-0155-z |
Alternate Journal | Bone Marrow Transplant. |
PubMed ID | 29581480 |
PubMed Central ID | PMC6158112 |
Grant List | U10 HL069294 / HL / NHLBI NIH HHS / United States U24 CA076518 / CA / NCI NIH HHS / United States |