TY - JOUR
T1 - Male survivors of allogeneic hematopoietic stem cell transplantation have a long term persisting risk of cardiovascular events
AU - Pophali, Priyanka A.
AU - Klotz, Jeffrey K.
AU - Ito, Sawa
AU - Jain, Natasha A.
AU - Koklanaris, Eleftheria
AU - Le, Robert Q.
AU - Hourigan, Christopher S.
AU - Savani, Bipin N.
AU - Chawla, Kamna
AU - Shanbhag, Sujata
AU - Barrett, A. John
AU - Battiwalla, Minoo
N1 - Funding Information:
This work was supported by the intramural research program of the National Institutes of Health Clinical Center and the National Heart, Lung, and Blood Institute .
PY - 2014/2
Y1 - 2014/2
N2 - Long-term survivors of allogeneic stem cell transplantation (SCT) have increased risk of cardiovascular disease. We retrospectively studied cardiovascular risk factors (CVRFs) in 109 SCT survivors (62 males, 47 females; median age 34 years) five years or more after bone marrow (15) or T cell-depleted peripheral blood (94) SCT for CML (56), acute leukemia (29), MDS (13), and others (11). One death and two cardiovascular events were reported. At five and ten years after SCT, respectively, 44% and 52% had abnormal lipid profiles; 23% of 5-year survivors met the Adult Treatment Panel III threshold for dyslipidemia treatment, which is substantially higher than the age-matched general population. There were significant increases in prevalence of hypertension (p < 0.001), diabetes (p = 0.018), and body mass index (p = 0.044) after SCT compared with baseline. The Framingham general cardiovascular risk score (FGCRS) in males at five years after SCT projected a doubling (median 10.4% vs. 5.4%) in the 10-year risk of cardiovascular events. Females received HRT after SCT, and none had increased FGCRS. Chronic GVHD and C-reactive protein were not associated with CVRF at any time. All CVRFs stabilized between five and ten years after SCT. Thus, SCT survivors have sustained elevations in CVRFs. Males have a significantly increased risk of cardiovascular events in their second and third decade after SCT.
AB - Long-term survivors of allogeneic stem cell transplantation (SCT) have increased risk of cardiovascular disease. We retrospectively studied cardiovascular risk factors (CVRFs) in 109 SCT survivors (62 males, 47 females; median age 34 years) five years or more after bone marrow (15) or T cell-depleted peripheral blood (94) SCT for CML (56), acute leukemia (29), MDS (13), and others (11). One death and two cardiovascular events were reported. At five and ten years after SCT, respectively, 44% and 52% had abnormal lipid profiles; 23% of 5-year survivors met the Adult Treatment Panel III threshold for dyslipidemia treatment, which is substantially higher than the age-matched general population. There were significant increases in prevalence of hypertension (p < 0.001), diabetes (p = 0.018), and body mass index (p = 0.044) after SCT compared with baseline. The Framingham general cardiovascular risk score (FGCRS) in males at five years after SCT projected a doubling (median 10.4% vs. 5.4%) in the 10-year risk of cardiovascular events. Females received HRT after SCT, and none had increased FGCRS. Chronic GVHD and C-reactive protein were not associated with CVRF at any time. All CVRFs stabilized between five and ten years after SCT. Thus, SCT survivors have sustained elevations in CVRFs. Males have a significantly increased risk of cardiovascular events in their second and third decade after SCT.
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U2 - 10.1016/j.exphem.2013.07.003
DO - 10.1016/j.exphem.2013.07.003
M3 - Article
C2 - 24141092
AN - SCOPUS:84896732181
SN - 0301-472X
VL - 42
SP - 83
EP - 89
JO - Experimental Hematology
JF - Experimental Hematology
IS - 2
ER -