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Coronary vessel involvement by chronic graft-versus-host disease presenting as sudden cardiac death

Bone Marrow Transplantation volume 34, pages 655–656 (2004)Cite this article

We report here the first case of histologically documented coronary vessel involvement exclusively due to chronic graft-versus-host disease (GVHD) causing a sudden myocardial infarction. Chronic GVHD involving the coronary arteries, with histological support, has been reported once before but the cause could not exclusively be attributed to chronic GVHD since the patient had received total body irradiation and anthracyclines.1 Chronic GVHD has been reported to affect the heart as pericardial effusion2 or arrhythmias.3

A 25-month-old male was diagnosed at 1 month of age with Wiskott–Aldrich Syndrome. At 4 months, he developed Pneumocystis carinii pneumonia. A bone marrow transplant using a female unrelated donor matched at A, B, and DR was performed. The donor and recipient were negative for CMV serology. The preparative regimen was busulphan 160 mg/m2/day p.o. divided q6 h from day −9 to −6, cyclophosphamide 50 mg/kg/day i.v. on days −5 through −3, and etoposide 500 mg/m2/day i.v. on days −5 through −3. Red cell-depleted marrow was infused at a dose of 6 × 108 nucleated cells/kg on day 0.

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Authors and Affiliations

  1. Division of Hematology/Oncology/Bone Marrow Transplantation, The Department of Pediatrics, British Columbia's Children's Hospital, Vancouver, British Columbia, Canada

    D Prevost & K R Schultz

  2. Division of Pathology, The Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Canada

    G Taylor

  3. Division of Cardiology, The Department of Pediatrics, British Columbia's Children's Hospital, Vancouver, British Columbia, Canada

    S Sanatani

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  1. D Prevost
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  2. G Taylor
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  3. S Sanatani
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  4. K R Schultz
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Prevost, D., Taylor, G., Sanatani, S. et al. Coronary vessel involvement by chronic graft-versus-host disease presenting as sudden cardiac death. Bone Marrow Transplant 34, 655–656 (2004). https://doi.org/10.1038/sj.bmt.1704625

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