Cardiac complications following hematopoietic stem cell transplantation (HSCT) are emerging as a significant concern given
the increasing utilization of HSCT for a variety of hematologic malignancies. Methods
We utilized an existing database to determine the frequency of cardiac dysfunction
(CD), namely a decrease in left ventricular ejection fraction, following conditioning with high‐dose melphalan (HDM) and autologous HSCT for multiple myeloma (MM) and systemic amyloidosis (AL).
We then performed a case–control study to examine variables associated with increased risk of CD in this population. Results
In MM patients
undergoing HSCT, the rate of CD was 1.6% (17/1050, 95% CI: [0.9, 2.6]). None of the examined pre‐HSCT variables or HDM dose were significantly associated with development of CD
in this population. In patients with AL, the rate of CD was 5.6% (24/426, 95% CI: [3.6, 8.3]). On univariate analysis, decision to administer an HDM dose <200 mg/m2 [odds ratio (OR):
4.59 (1.27–16.57) P = 0.02], pretransplant left ventricular ejection fraction <60% [OR: 17.78 (2.29–138.33) P = 0.006], and documented amyloid involvement of ≥3 organs [OR: 4.0 (1.03–15.6) P = 0.046]
were associated with the development of CD in the AL population. No other examined peri‐transplant factors were associated with development of CD. Conclusion
To our knowledge, this is the first series to report a significant rate of CD following HDM conditioning and autologous HSCT in patients with AL.
No Supplementary Data
No Article Media
Document Type: Research Article
Publication date: September 1, 2012