title: Acute systolic dysfunction within two weeks of high-dose chemotherapy conditioning before autologous bone marrow transplant: a case report.
abstract: Studies have shown various cardiotoxic effects of high-dose chemotherapy (HDC) used for conditioning before autologous bone marrow transplant (ABMT) including arrhythmias but only a transient small decrease in left ventricle ejection fraction (LVEF). To our knowledge, an acute dramatic decrease in LVEF after HDC preconditioning has never been reported. We report a patient presenting with an acutely symptomatic heart failure within 2 weeks of receiving HDC conditioning for ABMT with an LVEF drop from normal to <30%. With stringent management and follow-up with regular echocardiograms for medication reconciliation, 5 months later she regained her LVEF of 50%.
authors.affiliation: Department of Internal Medicine, Health Sciences Center, University of Oklahoma, Oklahoma City, Oklahoma 73104, USA.
authors.forename: Raghav
authors.initials: R
authors.lastname: Gupta
authors.forename: Christina
authors.initials: C
authors.lastname: Murray
authors.forename: Ralph
authors.initials: R
authors.lastname: Lazzara
authors.forename: C A
authors.initials: CA
authors.lastname: Sivaram
mesh_terms: D000208:Acute Disease; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000379:methods*; D002302:Cardiac Output; D003520:Cyclophosphamide / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D054143:Heart Failure, Systolic / Q000139:chemically induced* / Q000000981:diagnostic imaging; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D020127:Recovery of Function; D018570:Risk Assessment; D012720:Severity of Illness Index; D013318:Stroke Volume; D013997:Time Factors; D019172:Transplantation Conditioning / Q000009:adverse effects* / Q000379:methods; D014182:Transplantation, Autologous; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced / Q000000981:diagnostic imaging
chemical_list: D003520:Cyclophosphamide