Increased pretransplant QT dispersion as a risk factor for the development of cardiac complications during and after preparative conditioning for pediatric allogeneic hematopoietic stem cell transplantation.
Although cardiac complications are some of the most serious complications of HSCT for leukemia, it is difficult to predict them. QTD has been reported as a predictor of heart failure and fatal arrhythmia in adults. The purpose of this study is to examine whether QTD predicts cardiac complications in pediatric HSCT. Eighteen patients (mean age, 6.9 yr; 11 ALL and seven AML) underwent high-dose cyclophosphamide treatment and total body irradiation as preparative conditioning for HSCT. QTD, QTcD, echocardiographic functional parameters, and cumulative anthracycline dose were evaluated. We compared these values between patients with and without cardiac complications. Among 18 patients, seven patients experienced cardiac complications (heart failure in four, arrhythmia in three). There were significant differences in QTD (43.7 ms in patients with cardiac complications vs. 30.2 ms in patients without the complications, p = 0.019) and QTcD (55.3 vs. 36.9 ms, p = 0.003) between the two groups. On the other hand, the cumulative dose of anthracycline and echocardiographic parameters were not significantly different between the two groups. Increases in QTD and QTcD during the pretreatment period may be risk factors for the development of cardiac complications during and after conditioning for pediatric HSCT.
Department of Pediatrics, Shinshu University School of Medicine, Matsumoto Department of Pediatrics, Nagano National Hospital, Ueda, Japan. nmotoki@shinshu-u.ac.jp
Noriko
N
Motoki
Takashi
T
Shimizu
Yohei
Y
Akazawa
Shoji
S
Saito
Miyuki
M
Tanaka
Ryu
R
Yanagisawa
Hirohiko
H
Motoki
Yozo
Y
Nakazawa
Kazuo
K
Sakashita
Yasushi
Y
Iwasaki
Masaaki
M
Shiohara
Kenichi
K
Koike
D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007223:Infant; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy; D012307:Risk Factors; D018709:Statistics, Nonparametric; D019172:Transplantation Conditioning / Q000009:adverse effects; D014184:Transplantation, Homologous
D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents