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Post-Transplant Complications

Cardiac conduction abnormalities in patients with breast cancer undergoing high-dose chemotherapy and stem cell transplantation

Bone Marrow Transplantation volume 25, pages 185–189 (2000)Cite this article

Abstract

Cardiac toxicities in 39 consecutive patients with breast cancer receiving high-dose chemotherapy (HDC) with stem cell transplantation were reviewed. All 39 patients received various anthracycline-containing regimens in adjuvant settings and/or for metastatic disease before HDC. As a cytoreductive regimen, all received cyclophosphamide 2000 mg/m2 and thiotepa 200 mg/m2 for 3 consecutive days. No immediate fatal toxicities were observed, but one patient developed chronic congestive heart failure and two had transient left ventricular dysfunction. Pericardial effusion was observed in another three patients. ST-T abnormalities during HDC were observed in two patients and arrhythmias were observed in nine, four of which occurred during stem cell infusion (SCI). There were three atrial arrhythmias, two ventricular arrhythmias, and four atrioventricular (AV)-block episodes. Two patients developed advanced and complete AV-block with an asystolic pause. Notably, three patients experienced AV-block with uncontrolled vomiting. No relationship was observed between the cumulative dose of anthracycline and cardiac toxicities during HDC. These results suggest that abnormalities in the conduction system during HDC may be more frequent than previously reported. Vagal reflex secondary to emesis may play an important role in the development of AV-block. Bone Marrow Transplantation (2000) 25, 185–189.

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Acknowledgements

We thank Akio Kohno, Takuya Fukushima, MD, and the nursing staff of the National Cancer Center Hospital for their excellent care of patients undergoing HDC. This work was supported in part by Grants-in-Aid for Cancer Research (2S-1, 5S-1, and 8S-1) from the Ministry of Health and Welfare of Japan.

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Author notes

  1. T Yokozawa & K Takeyama

    Present address: First Department of Internal Medicine, Nagoya University School of Medicine, Nagoya, Japan

Authors and Affiliations

  1. Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan

    M Ando, T Yokozawa, Y Takaue, K Togitani, N Kawahigashi, M Narabayashi, K Takeyama, R Tanosaki, S Mineishi, Y Kobayashi, T Watanabe, I Adachi & K Tobinai

  2. Cardiovascular Institute, Tokyo, Japan

    J Sawada

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Ando, M., Yokozawa, T., Sawada, J. et al. Cardiac conduction abnormalities in patients with breast cancer undergoing high-dose chemotherapy and stem cell transplantation. Bone Marrow Transplant 25, 185–189 (2000). https://doi.org/10.1038/sj.bmt.1702106

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  • DOI: https://doi.org/10.1038/sj.bmt.1702106

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