Evaluation of pretransplant factors predicting cardiac dysfunction following high-dose melphalan conditioning and autologous peripheral blood stem cell transplantation

Jonathan S. Bleeker, Morie A. Gertz, Patricia A. Pellikka, Dirk R. Larson, Francis Buadi, David Dingli, Angela Dispenzieri, Suzanne R. Hayman, William Hogan, Shaji Kumar, S. Vincent Rajkumar, Martha Q. Lacy

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Background: 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/m 2 [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.

Original languageEnglish (US)
Pages (from-to)228-235
Number of pages8
JournalEuropean Journal of Haematology
Volume89
Issue number3
DOIs
StatePublished - Sep 1 2012

Keywords

  • Amyloidosis
  • Cardiomyopathy
  • High-dose melphalan
  • Multiple myeloma
  • Stem cell transplant

ASJC Scopus subject areas

  • Hematology

Fingerprint Dive into the research topics of 'Evaluation of pretransplant factors predicting cardiac dysfunction following high-dose melphalan conditioning and autologous peripheral blood stem cell transplantation'. Together they form a unique fingerprint.

  • Cite this