title: Cardiac toxicity of bone marrow transplantation: predictive value of cardiologic evaluation before transplant.
abstract: OBJECTIVE
  This study analyses the risk of cardiac complications and its individual predictability in bone marrow transplantation (BMT).
  
  
  METHODS
  One hundred seventy patients undergoing allogeneic (n = 150) or autologous (n = 20) BMT were evaluated by physical examination, history, rest and exercise ECG, chest x-ray, two-dimensional echocardiography, and radionuclide ventriculography (RNV) before BMT, and monitored for 3 months thereafter.
  
  
  RESULTS
  Following BMT, cardiac toxicity occurred in eight patients (4.7%). Three patients (1.8%) developed life-threatening toxicity (pericardial effusion and left ventricular failure, n = 2; sudden cardiac arrest, n = 1). Thirty-eight patients (22%) had pathologic findings before BMT. In 22 patients, left ventricular ejection fraction (EF) determined by RNV was reduced to less than 55%. This was the only abnormality in 17 patients and was generally mild, with a lowest EF of 42%. There was no correlation between overall results of cardiologic evaluation before BMT and cardiac toxicity. Cardiotoxic events occurred more frequently in patients with a reduced EF (P < .05). However, this was restricted to minor cardiac events. Life-threatening cardiac toxicity was not significantly increased in patients with pathologic results before BMT. Moreover, none of the patients with an EF less than 50% developed cardiac toxicity.
  
  
  CONCLUSIONS
  Life-threatening cardiac toxicity is rare after BMT, occurring in less than 2% of all patients. Although the occurrence of cardiac toxicity is correlated with a reduction of EF before BMT, life-threatening cardiac toxicity cannot be predicted in individual patients.
authors.affiliation: Department of Internal Medicine III (Hematology and Oncology), University of Ulm, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Hertenstein
authors.forename: M
authors.initials: M
authors.lastname: Stefanic
authors.forename: T
authors.initials: T
authors.lastname: Schmeiser
authors.forename: M
authors.initials: M
authors.lastname: Scholz
authors.forename: V
authors.initials: V
authors.lastname: Göller
authors.forename: M
authors.initials: M
authors.lastname: Clausen
authors.forename: D
authors.initials: D
authors.lastname: Bunjes
authors.forename: M
authors.initials: M
authors.lastname: Wiesneth
authors.forename: J
authors.initials: J
authors.lastname: Novotny
authors.forename: M
authors.initials: M
authors.lastname: Kochs
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000209:etiology; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D003131:Combined Modality Therapy; D005260:Female; D006321:Heart / Q000502:physiology*; D006323:Heart Arrest / Q000209:etiology; D006331:Heart Diseases / Q000209:etiology*; D006333:Heart Failure / Q000209:etiology; D006334:Heart Function Tests; D006402:Hematologic Diseases / Q000628:therapy; D006801:Humans; D007938:Leukemia / Q000628:therapy; D008223:Lymphoma / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000209:etiology; D011237:Predictive Value of Tests; D012306:Risk; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous
chemical_list: D000970:Antineoplastic Agents