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Cardiac events occurring after allogeneic hematopoietic cell transplantation with post-transplant cyclophosphamide. Study conducted on behalf of the GETH-TC

Bone Marrow Transplantation volume 59, pages 1694–1703 (2024)Cite this article

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Abstract

This multicenter study investigates the incidence and predictors of cardiac events (CE) following allo-HCT with PTCY in 453 AML patients. CE occurred in 57 (12.3%) patients within a median of 52 days (IQR: 13–289), with day 100 and 5-year cumulative incidences of 7.7% and 13.5%. Early (first 100 days) and late CE occurred at rates of 7.7% and 4.8%. The most prevalent CE were heart failure (n = 18, 31.6%), pericardial complications (n = 16, 28.1%), and arrhythmia (n = 14, 24.6%). The proportions of patients older than 55 years (64.9% vs. 46.1%, P = 0.010), with hypertension (36.8% vs. 18.4%, P = 0.001) and dyslipidemia (28.1% vs. 11.1%, P = 0.001) were higher in patients with CE. Patients undergoing haplo-HCT trend to have more CE (68.4% vs. 56.8%, P = 0.083). The multivariate regression analysis revealed that only hypertension (HR 1.88, P = 0.036) and dyslipidemia (HR 2.20, P = 0.018) were predictors for CE, with no differences according to donor type (haplo-HCT vs. others: HR 1.33, P = 0.323). Among the 57 patients with CE, the mortality rate was 12.2%. Notably, the diagnosis of CE negatively impacted NRM (HR 2.57, P = 0.011) and OS (HR 1.80, P = 0.009), underscoring necessity of aggressively treating cardiovascular risk factors, and implementing post-transplant cardiac monitoring protocols to prevent these complications.

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Acknowledgements

We thank our patients and the nursing and support staff in the Hematopoietic Cell Transplant Programs and the Cardiology Departments participating in the study and the support provided by the Grupo Español de Trasplante de Progenitores Hematopoyéticos y Terapia Celular. We additionally thank REDCap (Research Electronic Data Capture) service for permitting the use of their service without costs. REDCap is a secure, web-based software platform designed to support data capture for research studies.

Author information

Author notes

  1. These authors contributed equally: María Queralt Salas, Enric Cascos.

Authors and Affiliations

  1. Hospital Clínic de Barcelona, Barcelona, Spain

    María Queralt Salas & Enric Cascos

  2. Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain

    Alberto López-García

  3. Complejo Asistencial Universitario de Salamanca/IBSAL, Salamanca, Spain

    Estefanía Pérez-López, Mónica Baile-González & Lucía López-Corral

  4. Hospital Regional Universitario de Málaga, Málaga, Spain

    María Jesús Pascual Cascón & Marta Luque

  5. Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

    Albert Esquirol

  6. Hospital General Universitario Morales Meseguer, Murcia, Spain

    Inmaculada Heras Fernando

  7. Hospital Universitario Donostia, Donostia, Spain

    Itziar Oiartzabal Ormtegi

  8. Hospital Universitario 12 de Octubre, Madrid, Spain

    Adolfo Jesús Sáez Marín

  9. Institut Català d’Oncologia - Hospital Duran i Reynals, Barcelona, Spain

    Felipe Peña-Muñóz

  10. Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain

    Sara Fernández-Luis & Juan José Domínguez-García

  11. Clínica Universidad de Navarra, Pamplona, Spain

    Sara Villar Fernández

  12. Hospital Universitario de Gran Canaria Doctor Negrín, Gran Canaria, Las Palmas, Spain

    Miguel Fernández de Sanmamed Girón & Leslie González Pinedo

  13. Hospital Universitario Central de Asturias, Oviedo, Spain

    Ana Pilar González-Rodríguez

  14. Hospital Universitario de A Coruña, A Coruña, Spain

    Tamara Torrado

  15. Hospital Universitario Son Espases, Palma de Mallorca, Spain

    Lucía García

  16. Grupo Español de Trasplante de Progenitores Hematopoyéticos y Terapia Celular, Madrid, Spain

    Silvia Filaferro, Ángel Cedillo, Pascual Basalobre, Guillermo Ortí & Manuel Jurado Chacón

  17. Hospital Universitari Vall d’Hebron, Barcelona, Spain

    Guillermo Ortí

  18. Hospital Universitario Virgen de las Nieves de Granada, Granada, Spain

    Manuel Jurado Chacón

Authors
  1. María Queralt Salas
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  2. Enric Cascos
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  3. Alberto López-García
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Contributions

MQS and EC designed the study, conducted the statistical analysis, and drafted the paper. The GETH-TC facilitated and endorsed the study’s execution. Dr. MJC provided valuable insights into the study’s execution and interpretation of results. All coinvestigators involved in the study have diligently collected the data and supported the integration of the results in the present manuscript. ALG, EP, MBG, LLC, MJPC, ML, AE, FPM, IHF, IQQ, AJSM, SFL, SVF, MFSG, LGP, APG, TT, LC, SF, AC, PB, GO and MJC contributed significantly to the study, offering valuable feedback, and critically reviewing and approving the manuscript.

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Correspondence to María Queralt Salas.

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Salas, M.Q., Cascos, E., López-García, A. et al. Cardiac events occurring after allogeneic hematopoietic cell transplantation with post-transplant cyclophosphamide. Study conducted on behalf of the GETH-TC. Bone Marrow Transplant 59, 1694–1703 (2024). https://doi.org/10.1038/s41409-024-02414-z

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