scholarly journals Outcome of Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Low Left Ventricular Ejection Fraction

2009 ◽  
Vol 15 (10) ◽  
pp. 1265-1270 ◽  
Author(s):  
Muzaffar H. Qazilbash ◽  
Ali Imran Amjad ◽  
Suhail Qureshi ◽  
Sofia R. Qureshi ◽  
Rima M. Saliba ◽  
...  
Keyword(s):  
Stem Cell ◽  
Left Ventricular Ejection Fraction ◽  
Hematopoietic Stem Cell Transplantation ◽  
Ejection Fraction ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Hematopoietic Stem ◽  
Ventricular Ejection Fraction

Treatment exposures stratify need for echocardiographic screening in asymptomatic long-term survivors of hematopoietic stem cell transplantation

2019 ◽  
Vol 29 (3) ◽  
pp. 338-343 ◽  
Author(s):  
Seth J. Rotz ◽  
Adam Powell ◽  
Kasiani C. Myers ◽  
Michael D. Taylor ◽  
John L. Jefferies ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Ejection Fraction ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Total Body Irradiation ◽  
Hematopoietic Stem ◽  
Total Body ◽  
Long Term Survivors

AbstractWe sought to define the prevalence of echocardiographic abnormalities in long-term survivors of paediatric hematopoietic stem cell transplantation and determine the utility of screening in asymptomatic patients. We analysed echocardiograms performed on survivors who underwent hematopoietic stem cell transplantation from 1982 to 2006. A total of 389 patients were alive in 2017, with 114 having an echocardiogram obtained ⩾5 years post-infusion. A total of 95 patients had echocardiogram performed for routine surveillance. The mean time post-hematopoietic stem cell transplantation was 13 years. Of 95 patients, 77 (82.1%) had ejection fraction measured, and 10/77 (13.0%) had ejection fraction z-scores ⩽−2.0, which is abnormally low. Those patients with abnormal ejection fraction were significantly more likely to have been exposed to anthracyclines or total body irradiation. Among individuals who received neither anthracyclines nor total body irradiation, only 1/31 (3.2%) was found to have an abnormal ejection fraction of 51.4%, z-score −2.73. In the cohort of 77 patients, the negative predictive value of having a normal ejection fraction given no exposure to total body irradiation or anthracyclines was 96.7% at 95% confidence interval (83.3–99.8%). Systolic dysfunction is relatively common in long-term survivors of paediatric hematopoietic stem cell transplantation who have received anthracyclines or total body irradiation. Survivors who are asymptomatic and did not receive radiation or anthracyclines likely do not require surveillance echocardiograms, unless otherwise indicated.

Abstract 72: Outcomes Of Patients With Left Ventricular Diastolic Dysfunction In Adult Hematopoietic Stem Cell Transplantation

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Kiran Garikapati ◽  
Syed Hassan ◽  
Aditi singhvi ◽  
Khoulani Dania ◽  
Sophia Qureshi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Diastolic Dysfunction ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Systolic Heart Failure ◽  
Left Ventricular ◽  
Hematopoietic Stem

Background: With better health care, hematopoietic stem cell transplantation has become possible for older patients. These patients have higher prevalence of diastolic dysfunction. However, it is not known if diastolic dysfunction has an impact on prognosis of these patients. Methods: Retrospective data was obtained for adults (>18 years) that underwent hematopoietic stem cell transplantation over a period of 1991 - 2012 (22 years). Demographic, echocardiogrpahic and mortality data were obtained. Cox proportional hazard model was used to analyze diastolic dysfunction as a predictor of mortality, graft versus host disease (GVHD), systolic heart failure (ejection fraction ≤50%) and sepsis. Diastolic dysfunction was defined according to American Society of Echocardiography guidelines. Results: Out of 770 patients (mean age 48.9±13.4, women 47.7%) had 91 (11.8%) patients with pre - transplant diastolic dysfunction. Patients with diastolic dysfunction were more likely to be older, hypertensive, ≥2 comorbidities and suffer from solid organ malignancy (p <0.05). Diastolic dysfunction was associated with GVHD (HR 2.69; 95% CI 1.42 - 5.10, p =0.002), post - transplant systolic heart failure (HR 3.25;95% CI 1.68 - 6.29, p=0.0001), 30 - day rehospitalizations (HR 1.81;95% CI 1.22 - 2.45, p = 0.003) and mortality (HR 2.62;95% CI 2.11 - 3.25, p = 0.0001). However, intensive care unit treatment, length of stay and sepsis were not associated with pre - transplant diastolic dysfunction. Conclusion: Pre - transplant diastolic dysfunction in this group of patients was associated with worse prognosis after transplantation. These findings might help guide therapies and early treatment/management of these patients, so that these complications might be prevented. <!--Copyright (c) 2006 Microsoft Corporation. All rights reserved.-->

Superior survival in primary systemic amyloidosis patients undergoing peripheral blood stem cell transplantation: a case-control study

Blood ◽  
2004 ◽  
Vol 103 (10) ◽  
pp. 3960-3963 ◽  
Author(s):  
Angela Dispenzieri ◽  
Robert A. Kyle ◽  
Martha Q. Lacy ◽  
Terry M. Therneau ◽  
Dirk R. Larson ◽  
...  
Keyword(s):  
Overall Survival ◽  
Stem Cell ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Peripheral Blood Stem Cell ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Control Study ◽  
Blood Stem Cell Transplantation

Abstract Primary systemic amyloidosis (AL) is a plasma cell dyscrasia resulting in multisystem failure and death. High-dose chemotherapy with peripheral blood stem cell transplantation (PBSCT) has been associated with higher response rates and seemingly higher overall survival than standard chemotherapy. Selection bias, however, confounds interpretation of these results. We performed a case-match-control study comparing overall survival of 63 AL patients undergoing transplantation with 63 patients not undergoing transplantation. Matching criteria included age, sex, time to presentation, left ventricular ejection fraction, serum creatinine, septal thickness, nerve involvement, 24-hour urine protein, and serum alkaline phosphatase. According to design, there was no difference between the groups with respect to sex (57% males), age (median, 53 years), left ventricular ejection fraction (65%), number of patients with peripheral nerve involvement (17%), cardiac interventricular septal wall thickness (12 mm), serum creatinine (1.1 mg/dL [97.24 μmol/L]), and bone marrow plasmacytosis (8%). Sixty-six patients have died (16 cases and 50 controls). For PBSCT and control groups, respectively, the 1-, 2-, and 4-year overall survival rates are 89% and 71%; 81% and 55%; and 71% and 41%. Outside a randomized clinical trial, these results present the strongest data supporting the role of PBSCT in selected patients with AL.

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