Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Post-Transplant Complications

Serious cardiac complications during bone marrow transplantation at the University of Minnesota, 1977–1997

Abstract

Cardiac complications may result from high-dose chemotherapy or irradiation administered during the conditioning phase of bone marrow and blood stem cell transplantation (BMT). To assess the frequency of clinically serious cardiac toxicity related to the acute phase of BMT, we retrospectively examined life-threatening or fatal cardiotoxicity identified using the complications records of our transplant center clinical database. All serious cardiac toxicity events within 100 days of BMT except those attributable to septic shock, pneumonitis or multi-organ failure were reviewed. Of 2821 BMT patients at the University of Minnesota between 1977 and 1997, 26 were identified as having suffered major or fatal (n = 13) cardiotoxicity (0.9%, 19 adults and seven children). Rapidly progressive heart failure resulted in death of 11 patients, one patient had fatal pericardial tamponade, and one had an acute ventricular fibrillation arrest. The remaining 13 patients (50%) had life-threatening cardiotoxicity including four patients with pericardial tamponade and nine patients with cardiac arrhythmias. Overall, we observed that acute, major cardiotoxic events attributable to BMT are uncommon, occurring with a frequency of <1%. These data suggest that with appropriate pre-transplant clinical evaluation, high-dose cyclophosphamide and irradiation in the BMT preparative phase does not result in frequent, clinically relevant short-term cardiac toxicity. Bone Marrow Transplantation (2001) 28, 283–287.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Buja LM, Ferrans VJ, Graw RG . Cardiac pathologic findings in patients treated with bone marrow transplantation Hum Pathol 1976 7: 17–45

    Article  CAS  PubMed  Google Scholar 

  2. Cazin B, Gorin NC, Laporte JP et al. Cardiac complications after bone marrow transplantation: a report on a series of 63 consecutive transplantations Cancer 1986 57: 2061–2069

    Article  CAS  PubMed  Google Scholar 

  3. Kupari M, Volin L, Suokas A et al. Cardiac involvement in bone marrow transplantation: electrographic changes, arrhythmias, heart failure and autopsy findings Bone Marrow Transplant 1990 5: 91–98

    CAS  PubMed  Google Scholar 

  4. Bearman SI, Petersen FB, Schor RA et al. Radionuclide ejection fractions in the evaluation of patients being considered for bone marrow transplantation: risk of cardiac toxicity Bone Marrow Transplant 1990 5: 173–177

    CAS  PubMed  Google Scholar 

  5. Kanj SS, Sharara AI, Shpall EJ et al. Myocardial ischemia associated with high-dose carmustine infusion Cancer 1991 68: 1910–1912

    Article  CAS  PubMed  Google Scholar 

  6. Vaickus L, Letendre L . Pericarditis induced by high-dose cytarabine therapy Arch Intern Med 1984 144: 1868–1869

    Article  CAS  PubMed  Google Scholar 

  7. Styler MJ, Topolsky DL, Crilley PA et al. Transient high grade heart block following autologous bone marrow infusion Bone Marrow Transplant 1992 10: 435–438

    CAS  PubMed  Google Scholar 

  8. Hertenstein B, Stefanic M, Schmeiser T et al. Cardiac toxicity of bone marrow transplantation: predictive value of cardiologic evaluation before transplant J Clin Oncol 1994 12: 998–1004

    Article  CAS  PubMed  Google Scholar 

  9. Anderlini O, Benjamin RS, Wong FC et al. Idarubicin cardiotoxicity: a retrospective study in acute myeloid leukemia and myelodysplasia J Clin Oncol 1995 13: 2827–2834

    Article  CAS  PubMed  Google Scholar 

  10. Crossley RJ . Clinical safety and tolerance of mitoxantrone Semin Oncol 1984 11: (Suppl. 1) 54–58

    CAS  PubMed  Google Scholar 

  11. Von Hoff DD, Rozencweig M, Layard M et al. Daunomycin-induced cardiotoxicity in children and adults: a review of 110 cases Am J Med 1977 62: 200–208

    Article  CAS  PubMed  Google Scholar 

  12. Appelbaum FR . Hammering away at solid tumors Cancer Treat Rep 1987 71: 115–117

    CAS  PubMed  Google Scholar 

  13. Baello EB, Ensberg ME, Fergusson DW et al. Effect of high-dose cyclophosphamide and total-body irradiation of left ventricular function in adult patients with leukemia undergoing allogeneic bone marrow transplantation Cancer Treat Rep 1986 70: 1187–1193

    CAS  PubMed  Google Scholar 

  14. Jain B, Floreani AA, Anderson JR et al. Cardiopulmonary function and autologous bone marrow transplantation: results and predictive value for respiratory failure and mortality Bone Marrow Transplant 1996 17: 561–568

    CAS  PubMed  Google Scholar 

  15. Braverman AC, Antin JH, Plappert MT et al. Cyclophosphamide cardiotoxicity in bone marrow transplantation: a prospective evaluation of new dosing regimens J Clin Oncol 1991 9: 1215–1223

    Article  CAS  PubMed  Google Scholar 

  16. Lipshultz SE, Colan SD, Gelber RD et al. Late cardiac effects of doxorubicin therapy for acute lymphoblastic leukemia in childhood New Engl J Med 1991 324: 808–815

    Article  CAS  PubMed  Google Scholar 

  17. Pihkala J, Saarinen UM, Lundstrom U et al. Effects of bone marrow transplantation on myocardial function in children Bone Marrow Transplant 1994 13: 149–155

    CAS  PubMed  Google Scholar 

  18. Kakavas PW, Ghalie R, Parrillo JE et al. Angiotensin converting enzyme inhibitors in bone marrow transplant recipients with depressed left ventricular function Bone Marrow Transplant 1995 15: 859–861

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Murdych, T., Weisdorf, D. Serious cardiac complications during bone marrow transplantation at the University of Minnesota, 1977–1997. Bone Marrow Transplant 28, 283–287 (2001). https://doi.org/10.1038/sj.bmt.1703133

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1703133

Keywords

This article is cited by

Search

Quick links