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Ahmad I, Souchet L, Hamzy F, Ceballos P, Desbrosses Y, Ravinet A, Turlure P, Villate A, Borel C, Benbarkat H, Yakoub-Agha I, Guillaume T. [Cardiac complications following allogeneic hematopoietic stem cell transplantation: Recommendations of the SFGM-TC]. Bull Cancer 2023; 110:S56-S66. [PMID: 35662519 DOI: 10.1016/j.bulcan.2022.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/22/2022] [Accepted: 03/30/2022] [Indexed: 10/18/2022]
Abstract
Autologous and allogeneic hematopoietic stem cell transplantation (HSCT) can lead to early cardiac complications as well as late sequelae. A cardiac evaluation is essential in the pre-transplant assessment given the patient's comorbidities and previous chemotherapy treatments received. Various thresholds of cardiac function are recommended as eligibility criteria. The rise of haplo-identical transplantation with the use of post-transplant high-dose cyclophosphamide (PT-Cy) as a prophylaxis against graft-versus-host disease (GVHD) is accompanied by a resurgence of cardiological concerns. Arrhythmias are also a concern and the list of drugs implicated in this complication is growing. The rare occurrence of cardiac GVHD has been reported, although the entity is not well defined. Finally, although long-term follow-up recommendations exist, they are not accompanied by specific targets for cardiovascular risk factors, the presence of which is nevertheless increased after HSCT. In the framework of the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) practice harmonization workshops held in Lille in September 2019, the prophylaxis, the diagnostic approach and the treatments of cardiac complication following HSCT were reviewed after analysis of published studies.
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Affiliation(s)
- Imran Ahmad
- Université de Montréal, hôpital Maisonneuve-Rosemont, service d'hématologie et oncologie médicale, 5415 Boulevard de l'Assomption, Montréal, QC, H1T2M4, Canada
| | - Laetitia Souchet
- Centre hospitalier La Pitié-Salpêtrière, service d'hématologie, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - Fati Hamzy
- Hôpital Universitaire International Cheikh Zaïd, Cite al Irfane-Hay Ryad, service d'hématologie et greffe de moelle osseuse, Av. Allal al Fassi, BP 6533, Rabat, Maroc
| | - Patrice Ceballos
- Centre hospitalier Saint-Éloi, UGH hématologie, 80, avenue Augustin-Fliche, 34080 Montpellier, France
| | - Yohann Desbrosses
- CHRU Jean-Minjoz Besançon, service d'hématologie, 3, boulevard Flemming, 25030 Besançon cedex, France
| | - Aurélie Ravinet
- CHU Estaing, université d'Auvergne, service d'hématologie, 1, place Lucie-Aubrac, 63000 Clermont-Ferrand, France
| | - Pascal Turlure
- CHU Dupuytren Limoges, service d'hématologie, 2, avenue Martin-Luther-King, 87000 Limoges, France
| | - Alban Villate
- CHU Bretonneau Tours, service d'hématologie et thérapie cellulaire, 2, boulevard Tonnelé, 37044 Tours cedex 9, France
| | - Cécile Borel
- Institut universitaire du cancer de Toulouse - Oncopole, service d'hématologie, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France
| | - Hanane Benbarkat
- Université de Montréal, hôpital Maisonneuve-Rosemont, service de cardiologie, 5415 Boulevard de l'Assomption, Montréal, QC, H1T2M4, Canada
| | - Ibrahim Yakoub-Agha
- CHU de Lille, université de Lille, service d'hématologie, Infinite, Inserm U1286, 59000 Lille, France
| | - Thierry Guillaume
- CHU de Nantes, Hôtel-Dieu, service d'hématologie clinique, 1, place Ricordeau, 44000 Nantes, France.
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Otto CM. Heartbeat: healthy lifestyles require community support, not just personal willpower. Heart 2022; 108:493-495. [PMID: 35273088 DOI: 10.1136/heartjnl-2022-321013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Catherine M Otto
- Division of Cardiology, University of Washington, Seattle, Washington, USA
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Emerson P, Deshmukh T, Stefani L, Mahendran S, Hogg M, Brown P, Panicker S, Altman M, Gottlieb D, Thomas L. Left atrial strain in cardiac surveillance of bone marrow transplant patients with prior anthracycline exposure. Int J Cardiol 2022; 354:68-74. [PMID: 35202739 DOI: 10.1016/j.ijcard.2022.02.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 01/31/2022] [Accepted: 02/16/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Bone marrow transplantation (BMT) has significantly improved survival rates in various hematological malignancies. However, this has led to an increased prevalence of long-term cardiotoxicity, particularly in those with prior anthracycline (AC) therapy. OBJECTIVES To evaluate changes in left atrial (LA) volume and function, including LA strain, in BMT patients with prior AC exposure and evaluate its utility as a marker of diastolic dysfunction. METHODS This was a cross-sectional analysis of 79 BMT patients with prior AC exposure who underwent a comprehensive surveillance transthoracic echocardiogram compared to age-matched healthy volunteers. Left ventricular (LV) and LA parameters were evaluated between the 2 groups. BMT patients were stratified using traditional measures of diastolic function and additionally utilizing LA strain. RESULTS LV systolic dysfunction with reduced LVEF (13/79) or global longitudinal strain (29/79) was present in BMT patients. There were no differences in LA volumes between the two groups. LA reservoir strain (30.1 ± 11.2% vs 34.1 ± 9.6%, p < 0.001) and LA conduit strain (13.6 ± 8.4% vs 17.0 ± 10.5%, p < 0.001) were reduced in the BMT group compared to controls. LA reservoir strain had modest correlation with mitral annular e' velocity (r = 0.468, p < 0.001). Using current diastolic function guidelines, 26/79 BMT patients had evidence of diastolic dysfunction. However, utilizing LA reservoir strain, an additional 35 patients were identified. CONCLUSIONS LA strain can identify early diastolic dysfunction in BMT patients with prior AC treatment. With diastolic dysfunction known to precede systolic dysfunction post AC, changes in LA reservoir strain may identify more patients with cardiac dysfunction, prompting increased surveillance and treatment.
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Affiliation(s)
- Peter Emerson
- Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia
| | - Tejas Deshmukh
- Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead Clinical School, The University of Sydney, NSW, Australia
| | - Luke Stefani
- Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia
| | | | - Megan Hogg
- Department of Haematology, Westmead Hospital, Sydney, NSW, Australia
| | - Paula Brown
- Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia
| | - Shyam Panicker
- Department of Haematology, Westmead Hospital, Sydney, NSW, Australia
| | - Mikhail Altman
- Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead Clinical School, The University of Sydney, NSW, Australia
| | - David Gottlieb
- Westmead Clinical School, The University of Sydney, NSW, Australia; Department of Haematology, Westmead Hospital, Sydney, NSW, Australia
| | - Liza Thomas
- Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; Westmead Clinical School, The University of Sydney, NSW, Australia; South West Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia.
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