title: Consensus statement concerning cardiotoxicity occurring during haematopoietic stem cell transplantation in the treatment of autoimmune diseases, with special reference to systemic sclerosis and multiple sclerosis.
abstract: Autologous haematopoietic stem cell transplantation is now a feasible and effective treatment for selected patients with severe autoimmune diseases. Worldwide, over 650 patients have been transplanted in the context of phase I and II clinical trials. The results are encouraging enough to begin randomised phase III trials. However, as predicted, significant transplant-related morbidity and mortality have been observed. This is primarily due to complications related to either the stage of the disease at transplant or due to infections. The number of deaths related to cardiac toxicity is low. However, caution is required when cyclophosphamide or anthracyclines such as mitoxantrone are used in patients with a possible underlying heart damage, for example, systemic sclerosis patients. In November 2002, a meeting was held in Florence, bringing together a number of experts in various fields, including rheumatology, cardiology, neurology, pharmacology and transplantation medicine. The object of the meeting was to analyse existing data, both published or available, in the European Group for Blood and Marrow Transplantation autoimmune disease database, and to propose a safe approach to such patients. A full cardiological assessment before and during the transplant emerged as the major recommendation.
authors.affiliation: Haematology Unit, University of Florence, Italy. r.saccardi@dac.unifi.it
authors.forename: R
authors.initials: R
authors.lastname: Saccardi
authors.forename: A
authors.initials: A
authors.lastname: Tyndall
authors.forename: G
authors.initials: G
authors.lastname: Coghlan
authors.forename: C
authors.initials: C
authors.lastname: Denton
authors.forename: G
authors.initials: G
authors.lastname: Edan
authors.forename: M
authors.initials: M
authors.lastname: Emdin
authors.forename: D
authors.initials: D
authors.lastname: Farge
authors.forename: A
authors.initials: A
authors.lastname: Fassas
authors.forename: J
authors.initials: J
authors.lastname: Finke
authors.forename: D
authors.initials: D
authors.lastname: Furst
authors.forename: M
authors.initials: M
authors.lastname: Lassus
authors.forename: G
authors.initials: G
authors.lastname: Mancardi
authors.forename: I
authors.initials: I
authors.lastname: Miniati
authors.forename: E
authors.initials: E
authors.lastname: Mini
authors.forename: F
authors.initials: F
authors.lastname: Pagliai
authors.forename: J
authors.initials: J
authors.lastname: Passweg
authors.forename: A
authors.initials: A
authors.lastname: Pignone
authors.forename: J M
authors.initials: JM
authors.lastname: van Laar
authors.forename: C
authors.initials: C
authors.lastname: Bocelli-Tyndall
authors.forename: M
authors.initials: M
authors.lastname: Matucci-Cerinic
mesh_terms: D018943:Anthracyclines / Q000009:adverse effects; D001327:Autoimmune Diseases / Q000150:complications / Q000628:therapy*; D003520:Cyclophosphamide / Q000009:adverse effects; D006331:Heart Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000209:etiology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D009103:Multiple Sclerosis / Q000150:complications / Q000628:therapy; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000150:complications / Q000628:therapy; D014182:Transplantation, Autologous
chemical_list: D018943:Anthracyclines; D003520:Cyclophosphamide