Cardiovascular disease and its management in children and adults undergoing hematopoietic stem cell transplantation

Seth J. Rotz, Thomas D. Ryan, Salim S. Hayek

Research output: Contribution to journalReview articlepeer-review

24 Scopus citations

Abstract

Hematopoietic stem cell transplantation (HSCT) is a potentially curative treatment for many malignancies, hemoglobinopathies, metabolic diseases, bone marrow failure syndromes, and primary immune deficiencies. Despite the significant improvement in survival afforded by HSCT, the therapy is associated with major short and long-term morbidity and mortality. Cardiovascular complications such as cardiomyopathy, arrhythmias, pulmonary hypertension, and pericardial effusions are increasingly recognized as potential outcomes following HSCT. The incidence of cardiac complications is related to various factors such as age, co-morbid medical conditions, whether patients received cardiotoxic chemotherapy prior to HSCT, the type of HSCT (autologous versus allogeneic), and the specific conditioning regimen. Thus, the cardiovascular evaluation has become a core component of the pre-transplant assessment, however, the practice differs from center to center as national guidelines and contemporary high-quality studies are lacking. We review the incidence of cardiotoxicity in pediatric and adult HSCT, potential mechanisms of injury, and effects on long-term outcomes. We also discuss the possible therapeutic approaches when disease arises, as well as the indications and need for surveillance before, during, and after transplantation.

Original languageEnglish (US)
Pages (from-to)854-869
Number of pages16
JournalJournal of Thrombosis and Thrombolysis
Volume51
Issue number4
DOIs
StatePublished - May 2021
Externally publishedYes

Keywords

  • Bone marrow transplantation
  • Cardiomyopathy
  • Cardiotoxicity
  • Heart failure
  • Outcomes
  • Pediatrics

ASJC Scopus subject areas

  • Hematology
  • Cardiology and Cardiovascular Medicine

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