title: Retrospective outcome data for hematopoietic stem cell transplantation in patients with concurrent coronary artery disease.
abstract: Hematopoietic stem cell transplantation (HSCT) represents an extended period of physiologic stress. It is unknown whether patients with pre-existing coronary artery disease (CAD) may be poor transplant candidates. There are no data analyzing the risk of transplantation in this population. Sixty-nine patients with CAD who underwent 72 transplantations, autologous and allogeneic, were identified retrospectively. Fifty-five percent of these patients had prior percutaneous coronary intervention, 42% had verifiable history of myocardial infarction, and 23% had prior coronary artery bypass grafting. Outcomes were compared to 1109 patients without established CAD who underwent 1183 transplants during the same time period. Cancer diagnoses in the 2 groups were similar, predominantly lymphoma, multiple myeloma, and leukemia. There was no significant difference between the CAD group and the control group with respect to type of transplant (autologous 68% versus 64%, P = .612, myeloablative 86% versus 85%, P = .867). Treatment-related mortality was no different in the CAD group versus the control group (5.6% versus 4.9%, P = .777), nor were there differences in mortality at 1 year (15.3% versus 16.6%, P = .871), urgent intensive care unit admission (11.1% versus 9.9%, P = .686), or length of stay (25.5 days versus 28.4 days, P = .195). These findings suggest many patients with underlying coronary artery disease may be safely managed through hematopoietic stem cell transplantation.
authors.affiliation: Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Stillwell
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Wessler
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Rebolledo
authors.forename: Richard M
authors.initials: RM
authors.lastname: Steingart
authors.forename: Erica L
authors.initials: EL
authors.lastname: Petrlik
authors.forename: Ann A
authors.initials: AA
authors.lastname: Jakubowski
authors.forename: Wendy L
authors.initials: WL
authors.lastname: Schaffer
mesh_terms: D001026:Coronary Artery Bypass / Q000379:methods; D003324:Coronary Artery Disease / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome