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Post-Transplant Events

Supraventricular tachyarrhythmias after hematopoietic stem cell transplantation: incidence, risk factors and outcomes

Bone Marrow Transplantation volume 34, pages 615–619 (2004)Cite this article

Summary:

Recent studies suggest that cancer patients may be at increased risk for supraventricular tachyarrhythmias (SVTA). We have observed clinically significant SVTA in patients undergoing hematopoietic stem cell transplantation occurring at a median of 6 days post transplant, manifesting as atrial fibrillation/flutter or regular narrow-complex tachycardia and persisting for a median of 3 days (range, 0–8). All patients received aggressive medical therapy and/or electrical cardioversion to restore sinus rhythm and to re-establish hemodynamic stability. Non-Hodgkin's lymphoma (NHL) was the most common diagnosis (53%), and a case control analysis in those patients demonstrated that SVTA occurred in 12% of patients and was associated with older age and pre-existing cardiac conditions. In conclusion, patients undergoing HSCT are at moderate risk for developing SVTA, particularly older patients with a diagnosis of NHL. These arrhythmias are clinically significant, and are a marker for increased mortality and prolonged hospital stay. Additional studies are needed to identify high-risk patients who may benefit from prophylactic anti-arrhythmic therapy.

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References

  1. Nicolini B, Rovelli A, Uderzo C . Cardiotoxicity in children after bone marrow transplantation. Pediatr Hematol Oncol 2000; 17: 203–209.

    Article  CAS  Google Scholar 

  2. Braverman AC, Antin JH, Plappert MT et al. Cyclophos-phamide cardiotoxicity: a prospective evaluation of new dosing regimens. J Clin Oncol 1991; 9: 1215–1223.

    Article  CAS  Google Scholar 

  3. Shan K, Lincoff AM, Young J . Anthracycline-induced cardiotoxicity. Ann Intern Med 1996; 125: 47–58.

    Article  CAS  Google Scholar 

  4. Alidina A, Lawrence D, Ford LA et al. Thiotepa-associated cardiomyopathy during blood or marrow transplantation: association with female sex and cardiac risk factors. Biol Blood Marrow Tranplant 1999; 5: 322–327.

    Article  CAS  Google Scholar 

  5. Alessandrino EP, Bernasconi P, Caldera D et al. Adverse events occurring during bone marrow or peripheral blood progenitor cell infusion: analysis of 126 cases. Bone Marrow Transplant 1999; 23: 533–537.

    Article  CAS  Google Scholar 

  6. Omotoso O, Khoury H, Brown R et al. Outcomes of stem cell transplant recipients requiring mechanical ventilation and cared for in the Bone marrow Transplant Unit. Blood 2001; 98: 350b.

    Google Scholar 

  7. Rubenfeld GD, Crawford SW . Withdrawing life support from mechanically ventilated recipients of bone marrow transplant: a case for evidence-based guidelines. Ann Intern Med 1996; 125: 625–633.

    Article  CAS  Google Scholar 

  8. Diaz de Heredia C, Moreno A, Olive T et al. Role of the intensive care unit in children undergoing bone marrow transplantation with life-threatening complications. Bone Marrow Transplant 1999; 24: 163–168.

    Article  CAS  Google Scholar 

  9. Jackson SR, Tweeddale MG, Barnett MJ et al. Admission of bone marrow transplant recipients to the intensive care unit: outcome, survival and prognostic factors. Bone Marrow Transplant 1998; 21: 697–704.

    Article  CAS  Google Scholar 

  10. Olivieri A, Corvatta L, Montanari M et al. Paroxysmal atrial fibrillation after high-dose melphalan in five patients autotransplanted with blood progenitor cells. Bone Marrow Transplant 1998; 21: 1049–1053.

    Article  CAS  Google Scholar 

  11. Cazin B, Gorin NC, Laporte JP et al. Cardiac complication after bone marrow transplantation. A report on a series of 63 consecutive patients. Cancer 1986; 57: 2061–2069.

    Article  CAS  Google Scholar 

  12. Kupari M, Volin L, Suokas A et al. Cardiac involvement in bone marrow transplantation: electrocardiographic changes, arrhythmias, heart failure and autopsy findings. Bone Marrow Transplant 1990; 5: 91–98.

    CAS  Google Scholar 

  13. Murdych T, Weisdorf DJ . Serious cardiac complication during bone marrow transplantation at the University of Minnesota, 1977–1997. Bone Marrow Transplant 2001; 28: 283–287.

    Article  CAS  Google Scholar 

  14. Van Besien K, Tabocoff J, Rodriguez M et al. High-dose chemotherapy with BEAC regimen and autologous bone marrow transplantation for intermediate grade and immunoblastic lymphoma: durable and complete remissions, but a high rate of regimen related toxicity. Bone Marrow Transplant 1995; 15: 549–555.

    CAS  Google Scholar 

  15. Brockstein BE, Smiley C, Al-Sadir J et al. Cardiac and pulmonary toxicity in patients undergoing high-dose chemotherapy for lymphoma and breast cancer: prognostic factors. Bone Marrow Transplant 2000; 25: 885–894.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank Kristan Augustin and Darrick Burgan for their help in computerized searches, and Kelly Dieckmann for secretarial support.

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Authors and Affiliations

  1. Division of Oncology, and Division of Cardiology, Department of Medicine, Section of BMT and Leukemia, Washington University School of Medicine, St Louis, MO, USA

    J D Hidalgo, R Krone, M W Rich, K Blum, D Adkins, M-Y Fan, R Brown, S Devine, T Graubert, W Blum, M Tomasson, L T Goodnough, R Vij, J DiPersio & H Khoury

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  1. J D Hidalgo
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  2. R Krone
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  3. M W Rich
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  4. K Blum
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  5. D Adkins
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  6. M-Y Fan
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  7. R Brown
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  8. S Devine
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  9. T Graubert
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  11. M Tomasson
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  12. L T Goodnough
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  14. J DiPersio
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  15. H Khoury
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Correspondence to H Khoury.

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Hidalgo, J., Krone, R., Rich, M. et al. Supraventricular tachyarrhythmias after hematopoietic stem cell transplantation: incidence, risk factors and outcomes. Bone Marrow Transplant 34, 615–619 (2004). https://doi.org/10.1038/sj.bmt.1704623

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  • DOI: https://doi.org/10.1038/sj.bmt.1704623

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