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A non-interventional study of microcirculation dynamics in allogeneic hematopoietic cell transplantation survivors compared to controls: evidence of impaired microvascular response regardless of conventional cardiovascular risk factors

Bone Marrow Transplantation volume 57, pages 72–77 (2022)Cite this article

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Abstract

Allogeneic hematopoietic cell transplantation (alloHCT) survivors have been recently recognized as patients at increased cardiovascular risk. We hypothesized that vascular function remains impaired in alloHCT survivors free of graft-versus-host-disease or relapse. We enrolled consecutive adult alloHCT survivors and non-HCT control individuals (January 2019–March 2020), matched for traditional cardiovascular risk factors. Microvascular dysfunction was dynamically assessed in real time by Laser Speckle Contrast Analysis (LASCA). Carotid-femoral pulse-wave velocity (PWV) and carotid intima media thickness (IMT) were assessed as surrogate markers of cardiovascular disease. We studied 75 patients after a median of 3.2 (range 2.1–4.9) years from alloHCT, who had suffered from grade 2 to 3 acute (20%) and/or moderate/severe chronic GVHD (42%), and 75 controls. Although traditional cardiovascular risk factors and surrogate markers of cardiovascular disease did not differ between groups, alloHCT survivors showed significantly impaired microvascular function (baseline and peak flux, time to peak, base to peak and base to occlusion change). LASCA indices were also independently associated with alloHCT. Our study shows for the first-time impaired microcirculation dynamics in alloHCT survivors, independently of cardiovascular risk factors. Additional studies are needed to address the role of novel markers in cardiovascular risk prediction, along with effects of disease type, phase, and pre-transplant treatments.

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Funding

This research is co-financed by Greece and the European Union (European Social Fund- ESF) through the Operational Programme “Human Resources Development, Education and Lifelong Learning 2014–2020” in the context of the project “Evaluation of novel markers of endothelial dysfunction and thrombotic microenvironment in patients with rheumatoid arthritis: association with markers of subclinical inflammation and cardiovascular damage (MIS 5047870)”. EG is also supported by the ASH Global Research Award.

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Author notes

  1. These authors contributed equally: Eleni Gavriilaki, Panagiota Anyfanti, Achilles Anagnostopoulos, Eugenia Gkaliagkousi.

Authors and Affiliations

  1. Hematology Department-BMT Unit, G Papanicolaou Hospital, Thessaloniki, Greece

    Eleni Gavriilaki, Ioanna Sakellari, Ioannis Batsis, Marianna Masmanidou, Zoi Bousiou, Anna Vardi & Achilles Anagnostopoulos

  2. 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Eleni Gavriilaki, Panagiota Anyfanti, Panagiotis Dolgyras, Antonios Lazaridis, Barbara Nikolaidou, Nikolaos Koletsos, Ippokratis Zarifis, Stella Douma & Eugenia Gkaliagkousi

  3. Laboratory of Clinical Neurophysiology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Maria Gavriilaki

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  1. Eleni Gavriilaki
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Contributions

Conceptualization, ELG and EG; Methodology, IS, PA, BN, MG; Software, AL, NK; Validation, IZ and MM; Formal analysis, ELG and PA; Investigation, IB, AV, and ZB; Resources, SD; Writing—original draft preparation, ELG; Writing—review and editing, EG, IS, AA; Supervision, SD and AA; Funding acquisition, EG and AP. All authors have read and agreed to the published version of the paper.

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Correspondence to Eleni Gavriilaki.

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Gavriilaki, E., Anyfanti, P., Sakellari, I. et al. A non-interventional study of microcirculation dynamics in allogeneic hematopoietic cell transplantation survivors compared to controls: evidence of impaired microvascular response regardless of conventional cardiovascular risk factors. Bone Marrow Transplant 57, 72–77 (2022). https://doi.org/10.1038/s41409-021-01500-w

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