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Transplant Toxicities

Cardiac QTc interval characteristics before and after hematopoietic stem cell transplantation: an analysis of 995 consecutive patients at a single center

Bone Marrow Transplantation volume 50, pages 954–960 (2015)Cite this article

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Abstract

Hematopoietic stem cell transplantation (HSCT) treats disorders affecting patients of all ages. We studied the rate-corrected cardiac QT interval (QTc) in 995 consecutive children and adults undergoing HSCT at the University of Minnesota. We sought to (1) describe QTc before and after HSCT; (2) describe the change in QTc after HSCT; (3) identify factors affecting QTc and its change; and (4) scrutinize an ‘at risk’ sub-cohort with a long QTc before HSCT. Pre HSCT: 952 (96%) patients had an evaluable electrocardiography (ECG); median QTc was 426 ms and depended upon disease necessitating transplant. Post HSCT: 506 (51%) patients had an evaluable ECG; median QTc was 441 ms. Intrapatient QTc change: 490 (49%) evaluable patients showed median QTc change (pre to post HSCT) of +16 ms (P<0.0001). At risk group: 68 patients were ‘at risk’ (long pre-HSCT QTc). In some, ‘at-risk’ status trended toward predictive of post-transplant nonrelapse mortality. QTc interval prolongation is evident in a large, diverse cohort undergoing HSCT at our institution. Prospective studies of this patient population may be warranted, particularly for ‘at-risk’ patients who demonstrate significant QTc prolongation both pre and post HSCT.

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Acknowledgements

Biostatistical support for this research publication was supported by NIH grants P30 CA77598 and P01 CA65493 utilizing the Biostatistics and Bioinformatics Core shared resource of the Masonic Cancer Center, University of Minnesota and by the by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number 8UL1TR000114-02. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author Contributions

WPM was involved in the concept/design, data collection, data analysis and writing/revision of the manuscript. RS performed data collection, data analysis and statistical support. PD was involved in the concept/design, data analysis and critical revision of manuscript.

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Authors and Affiliations

  1. Division of Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA

    W P Miller

  2. Biostatistics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA

    R Shanley

  3. Division of Pediatric Cardiology, University of Minnesota, Minneapolis, MN, USA

    P Dorostkar

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  1. W P Miller
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Correspondence to W P Miller.

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Miller, W., Shanley, R. & Dorostkar, P. Cardiac QTc interval characteristics before and after hematopoietic stem cell transplantation: an analysis of 995 consecutive patients at a single center. Bone Marrow Transplant 50, 954–960 (2015). https://doi.org/10.1038/bmt.2015.64

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