Cardiovascular Considerations in Patients Undergoing Hematopoietic Stem Cell Transplantation

Hematopoietic stem cell transplantation (HSCT) is increasingly used for the treatment of many malignancies in older patients with multimorbidity-including cardiovascular disease and risk factors-who represent a growing proportion of eligible candidates. Short- and long-term cardiovascular complications of HSCT are diverse, with complex pathophysiology related to the conditioning regimen and hyperinflammatory nature of HSCT. This chapter aims to summarize available data on the incidence of acute and long-term cardiotoxicities and potential mechanisms of cardiac complications and provide guidance surrounding the cardiovascular management of patients throughout the transplant process from the pre-transplant assessment to survivorship. While data guiding the pre-HSCT and post-HSCT cardiovascular assessment are lacking, specialists in cardio-oncology can play a crucial role in minimizing the impact of preexisting cardiovascular disease on transplant outcomes and address cardiovascular complications both during HSCT and in survivorship.