title: Cardiac QTc interval characteristics before and after hematopoietic stem cell transplantation: an analysis of 995 consecutive patients at a single center.
abstract: Hematopoietic stem cell transplantation (HSCT) treats disorders affecting patients of all ages. We studied the rate-corrected cardiac QT interval (QTc) in 995 consecutive children and adults undergoing HSCT at the University of Minnesota. We sought to (1) describe QTc before and after HSCT; (2) describe the change in QTc after HSCT; (3) identify factors affecting QTc and its change; and (4) scrutinize an 'at risk' sub-cohort with a long QTc before HSCT. Pre HSCT: 952 (96%) patients had an evaluable electrocardiography (ECG); median QTc was 426 ms and depended upon disease necessitating transplant. Post HSCT: 506 (51%) patients had an evaluable ECG; median QTc was 441 ms. Intrapatient QTc change: 490 (49%) evaluable patients showed median QTc change (pre to post HSCT) of +16 ms (P<0.0001). At risk group: 68 patients were 'at risk' (long pre-HSCT QTc). In some, 'at-risk' status trended toward predictive of post-transplant nonrelapse mortality. QTc interval prolongation is evident in a large, diverse cohort undergoing HSCT at our institution. Prospective studies of this patient population may be warranted, particularly for 'at-risk' patients who demonstrate significant QTc prolongation both pre and post HSCT.
authors.affiliation: Division of Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
authors.forename: W P
authors.initials: WP
authors.lastname: Miller
authors.affiliation: Biostatistics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA.
authors.forename: R
authors.initials: R
authors.lastname: Shanley
authors.affiliation: Division of Pediatric Cardiology, University of Minnesota, Minneapolis, MN, USA.
authors.forename: P
authors.initials: P
authors.lastname: Dorostkar
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007223:Infant; D008133:Long QT Syndrome / Q000175:diagnosis*; D008297:Male; D011379:Prognosis; D019172:Transplantation Conditioning / Q000379:methods*; D055815:Young Adult
references.citation: J Clin Oncol. 2007 Dec 1;25(34):5471-89
references.pmid: 17909198
references.citation: Clin Adv Hematol Oncol. 2007 Jul;5(7):560-70
references.pmid: 17679930
references.citation: Br J Haematol. 2010 Aug;150(3):251-8
references.pmid: 20560963
references.citation: J Electrocardiol. 2005 Oct;38(4 Suppl):69-73
references.pmid: 16226078
references.citation: Biol Blood Marrow Transplant. 2015 Apr;21(4):620-4
references.pmid: 25246296
references.citation: J Pediatr. 2007 Oct;151(4):340-6
references.pmid: 17889065
references.citation: J Clin Oncol. 1993 Oct;11(10):1906-10
references.pmid: 8410117
references.citation: Clin Infect Dis. 2004 Sep 15;39(6):e49-52
references.pmid: 15472801
references.citation: Cardiol J. 2007;14(6):523-33
references.pmid: 18651517
references.citation: Bone Marrow Transplant. 2008 Jan;41(2):173-82
references.pmid: 18037944
references.citation: Pediatr Res. 2006 Jan;59(1):27-32
references.pmid: 16326988
references.citation: Blood. 2005 Oct 15;106(8):2912-9
references.pmid: 15994282
references.citation: N Engl J Med. 2004 Mar 4;350(10):1013-22
references.pmid: 14999113
references.citation: Pediatr Clin North Am. 2010 Feb;57(1):147-70
references.pmid: 20307716
references.citation: Am J Cardiol. 1993 Aug 26;72(6):23B-25B
references.pmid: 8256751
references.citation: Cleve Clin J Med. 2008 Aug;75(8):591-600
references.pmid: 18756841
references.citation: Heart Dis Stroke. 1992 Sep-Oct;1(5):309-14
references.pmid: 1344123
references.citation: Heart Rhythm. 2010 Jan;7(1):117-26
references.pmid: 19875343
references.citation: Curr Probl Cardiol. 2008 Nov;33(11):629-94
references.pmid: 18835466
references.citation: Ann Noninvasive Electrocardiol. 2010 Jan;15(1):1-2
references.pmid: 20146775
references.citation: Pediatr Transplant. 2010 Dec;14(8):986-92
references.pmid: 21108706
references.citation: Int J Antimicrob Agents. 2009 Nov;34(5):494-6
references.pmid: 19570657
references.citation: Am J Hematol. 2004 May;76(1):1-7
references.pmid: 15114589
references.citation: J Pediatr. 1984 Sep;105(3):442-4
references.pmid: 6590827
references.citation: Semin Hematol. 2010 Jan;47(1):79-85
references.pmid: 20109615
references.citation: Am J Cardiol. 2009 Oct 1;104(7):990-4
references.pmid: 19766769
references.citation: Curr Probl Cardiol. 2008 Apr;33(4):163-96
references.pmid: 18319102
references.citation: Curr Drug Saf. 2010 Jan;5(1):93-6
references.pmid: 20210725
references.citation: Cancer Control. 2011 Oct;18(4):246-57
references.pmid: 21976243
references.citation: Biol Blood Marrow Transplant. 2012 Jan;18(1 Suppl):S166-71
references.pmid: 22226101
references.citation: Cancer. 2010 Mar 15;116(6):1582-91
references.pmid: 20108303
references.citation: Stat Med. 1997 Apr 30;16(8):901-10
references.pmid: 9160487
references.citation: Biol Blood Marrow Transplant. 2012 Jan;18(1 Suppl):S33-9
references.pmid: 22226110
references.citation: Clin Cancer Res. 2008 Sep 1;14(17):5325-31
references.pmid: 18765523
references.citation: Heart Rhythm. 2009 Aug;6(8):1202-8, 1208.e1
references.pmid: 19632634