Outcomes of Patients with Myeloid Malignancies and Cardiovascular Disease Undergoing Allogeneic Stem Cell Transplantation.

Autor:	Sanchez-Petitto G; Division of Hematology and Oncology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA., Goloubeva O; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.; University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA., Childress J; Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA., Iqbal T; Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA., Masur J; Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA., An M; Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA., Muhammad S; Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA., Lawson J; University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA., Li G; University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA., Barr B; Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA., Emadi A; Division of Hematology and Oncology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.; University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA., Duong VH; Division of Hematology and Oncology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.; University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA., Hardy NM; Division of Hematology and Oncology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.; University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA., Rapoport AP; Division of Hematology and Oncology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.; University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA., Baer MR; Division of Hematology and Oncology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.; University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA., Niyongere S; Division of Hematology and Oncology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.; University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA., Yared JA; Division of Hematology and Oncology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.; University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA.
Jazyk:	angličtina
Zdroj:	Acta haematologica [Acta Haematol] 2024 Aug 27, pp. 1-12. Date of Electronic Publication: 2024 Aug 27.
DOI:	10.1159/000541131
Abstrakt:	Introduction/background: Reduced-intensity conditioning (RIC) and nonmyeloablative (NMA) regimens have enabled patients with cardiovascular disease (CVD) to undergo allogeneic stem cell transplantation (allo-HSCT). However, little is known about long-term outcomes, including cardiovascular (CV) complications. Methods: We retrospectively studied 99 consecutive patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) who underwent allo-HSCT between September 1, 2013, and November 30, 2020. Overall survival (OS), progression-free survival (PFS), nonrelapse mortality (NRM), cumulative incidence of relapse, and cumulative incidence of acute and chronic graft-versus-host disease (GvHD) were compared in patients with and without CV risk factors or disease. Results: Preexisting CVD was present in 34 of 99 patients (34%). CVD patients more commonly had reduced-intensity conditioning (91% vs. 60%, p = 0.001) and unrelated donors (56% vs. 35%, p = 0.04). Early adverse cardiac events occurred more frequently in the CVD versus no-CVD group (38% vs. 14%), particularly arrhythmias (21% vs. 5%; p = 0.04). CVD patients tended to have poorer OS and PFS outcomes (HR = 1.98, [1.00, 3.92]; HR = 1.89, [0.96-3.72], respectively). OS rate at 1, 2, and 3 years for CVD versus no-CVD patients was 66% versus 72%, 55% versus 64%, and 46% versus 62%, respectively. Causes of death in the CVD and no-CVD groups were infections (53% vs. 28%), relapsed disease (32% vs. 52%), and CV events (10% vs. 3%). Conclusion: Based on these data, predictive models to identify patients with CVD with higher risk of post-allo-HSCT complications and mortality and strategies to mitigate these risks should be developed. (© 2024 S. Karger AG, Basel.)
Databáze:	MEDLINE
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