Cardiac adverse events during stem cell transplantation for hematological malignancies: A single centre experience
Introduction
Hematopoietic stem cell transplantation (SCT) is a curative and highly successful treatment option for many hematological malignancies [1]. Several adverse effects can be seen both in autologous and allogeneic SCT due to the infusion and damage caused by the transplantation conditioning regimens. Infusion-related adverse effects during the autologous transplantation have generally been linked to dimethyl sulfoxide (DMSO) which is used as cryoprotectant. [2], [3], [4].
Cardiovascular adverse effects are relatively common during SCT, and they have the potential to cause devastating complications [5]. These effects have also been known to increase the long-term incidence of co-morbidity. However, the etiology and predisposing factors of cardiovascular adverse effects are not clearly defined [6].
The aim of the present study was to evaluate the transplantation-related cardiac adverse effects and determine the risk factors in patients receiving autologous and allogeneic SCT at our institution.
Section snippets
Study design and patient selection
A retrospective analysis of 622 consecutive patients with hematological malignancies, received autologous or allogeneic SCT, followed at the Hacettepe University Department of Haematology Stem Cell Transplantation Unit between 2005 and 2019 were enrolled. Medical history, physical examination, systolic and diastolic blood pressure (BP) measurements, demographic characteristics including age, gender, and body mass index, smoking status, creatinine level and transplantation related data including
Results
Baseline demographic characteristics, laboratory findings, disease status, and infusion related parameters of all population and autologous and allogeneic SCT groups are presented in Table 1. Of 622 patients, 318 (51.1 %) received autologous and 304 (48.9 %) received allogeneic SCT. The most commonly transplanted disease was acute leukemia with 244 (39.2 %) patients followed by multiple myeloma with 233 (37.5 %) patients. Then, 107 (17.2 %), 30 (4.8 %), and 8 (1.3 %) patients received SCT due
Discussion
The purpose of the present study was to evaluate the cardiac adverse events during SCT in patients with hematologic malignancies. The incidence of cardiac adverse events that consist of hypertension, hypotension / bradycardia, tachyarrhythmia and cardiac arrest was found to be 10.8 %. In addition, the most common adverse effect was tachyarrhythmia and no difference was found between hematologic malignancies regarding these cardiac adverse events.
Cardiac adverse events may be seen during SCT
Conclusion
Cardiac adverse events are relatively common during SCT; however, life-threatening events are extremely rare. These adverse effects appear to be related to the type of transplantation rather than the underlying disease. Patients undergoing SCT should be closely monitored during the peri-transplantation period to identify the cardiac adverse events early to minimize the risks of subsequent complications. In our institution, in the pre-transplantation period, patients with high risk for
References (16)
- et al.
Premature cardiovascular disease after allogeneic hematopoietic stem-cell transplantation
Blood
(2007) - et al.
Incidence of supraventricular arrhythmias during autologous peripheral blood stem cell transplantation
Biol Blood Marrow Transplant
(2013) - et al.
Indications for haematopoietic stem cell transplantation for haematological diseases, solid tumours and immune disorders: current practice in Europe, 2019
Bone Marrow Transplant
(2019) - et al.
Precipitation of ventricular bigeminy by DMSO during autologous haematopoietic stem cell transplantation
Transfus Med
(2015) - et al.
Subcommittee ECLWPC. Variation in dimethyl sulfoxide use in stem cell transplantation: a survey of EBMT centres
Bone Marrow Transplant
(2005) - et al.
Adverse reactions during transfusion of thawed haematopoietic progenitor cells from apheresis are closely related to the number of granulocyte cells in the leukapheresis product
Vox Sang
(2010) - et al.
Cardiac complications in patients undergoing a reduced-intensity conditioning hematopoietic stem cell transplantation
Bone Marrow Transplant
(2010) - et al.
Adverse events during hematopoietic stem cell infusion: analysis of the infusion product
Clin Lmphoma Myeloma Leuk
(2015)