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Post-Transplant Events

Characteristics and outcome of patients developing endocarditis following hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 34, pages 969–973 (2004)Cite this article

Summary:

Endocarditis is an uncommon complication of hematopoietic stem cell transplantation (HSCT). A retrospective review of 1547 patients who underwent HSCT in Vancouver between January 1986 and December 2001 was performed. In all, 20 cases of endocarditis were identified (1.3% of all patients) with nine patients having received cryopreserved autologous stem cells, six stem cells from a histocompatible sibling and five patients stem cells from an unrelated donor. Five patients had endocarditis diagnosed while alive, a median of 6 months post-HSCT, by transthoracic (four patients) or transesophageal (one patient) echocardiography. The remaining 15 cases of endocarditis were only identified post mortem. The mitral valve was the most frequently involved (10 patients) followed by the aortic valve (six patients); multivalvular disease was noted in five patients. Of the 11 affected allogeneic HSCT patients, 10 had previously developed acute graft-versus-host disease (GVHD). Causative organisms were identified in 11 patients, while nine additional cases were felt to be thrombotic in origin. Of the 20 patients, 19 died with the sole survivor alive 10 years following an aortic valve replacement. Endocarditis is an uncommon complication of HSCT usually involving the cardiac valves on the left side of the heart and is associated with a high mortality rate.

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Acknowledgements

We acknowledge the contributions of the medical and nursing staff of Tower 15A Ward and BMT Daycare at the Vancouver General Hospital and the staff of 6 West at the British Columbia Cancer Agency.

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Authors and Affiliations

  1. The Leukemia and Bone Marrow Transplantation Program of British Columbia: Division of Hematology, Vancouver General Hospital, British Columbia Cancer Agency and the University of British Columbia, Vancouver, Canada

    J Kuruvilla, D L Forrest, J C Lavoie, S H Nantel, J D Shepherd, K W Song, H J Sutherland, C L Toze, D E Hogge & T J Nevill

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  1. J Kuruvilla
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  2. D L Forrest
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  3. J C Lavoie
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  4. S H Nantel
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  5. J D Shepherd
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  6. K W Song
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  7. H J Sutherland
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  8. C L Toze
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  9. D E Hogge
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  10. T J Nevill
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Correspondence to T J Nevill.

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Kuruvilla, J., Forrest, D., Lavoie, J. et al. Characteristics and outcome of patients developing endocarditis following hematopoietic stem cell transplantation. Bone Marrow Transplant 34, 969–973 (2004). https://doi.org/10.1038/sj.bmt.1704655

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  • DOI: https://doi.org/10.1038/sj.bmt.1704655

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