PMID: 30802024Mar 1, 2017Paper

The Role of Laboratory Medicine in Hematopoietic Stem Cell Transplantation "Echocardiogram"

Rinsho byori. The Japanese journal of clinical pathology
Mitsutaka Nishimoto, Junichi Yoshikawa

Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative therapy for hematologic ma- lignancies. However, there are some potentially fatal complications, including graft-versus-host disease or infections, and transplant-related mortality is still high. One of the life-threatening complications related to allo-HSCT is cardiotoxicity. There are several causes of cardiotoxicity, such as pre-transplant chemothera- py, conditioning chemotherapy, cytokine storms due to sepsis or allogeneic immune reactions, rapid altera- tion of body fluid, and ischemic heart disease caused by transplant-associated thrombotic microangiopathy or calcineurin inhibitors. Echocardiography is a very useful and convenient method when assessing the cardiac function in daily clin- ics. The ejection fraction is a useful surrogate marker of the cardiac systolic function, and the trans-mitral valve inflow pattern is a useful surrogate marker of the cardiac diastolic function. There are several causes of cardiotoxicity during the course of allo-HSCT. In the pre-phase of allo-HSCT, the cumulative dose of anthracycline before transplantation is correlated with the rate of cardiac complications. In the acute phase of allo-HSCT, we should bear in...Continue Reading

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