title: Cardiovascular disease following hematopoietic stem cell transplantation: Pathogenesis, detection, and the cardioprotective role of aerobic training.
abstract: Advances in hematopoietic cell transplantation (HCT) techniques and supportive care strategies have led to dramatic improvements in relapse mortality in patients with high-risk hematological malignancies. These improvements, however, conversely increase the risk of late-occurring non-cancer competing causes, mostly cardiovascular disease (CVD). HCT recipients have a significantly increased risk of CVD-specific mortality, including elevated incidence of coronary artery disease (CAD), cerebrovascular disease, and heart failure (HF) compared to age-matched counterparts. Accordingly, there is an urgent need to identify techniques for the detection of early CVD in HCT patients to inform early prevention strategies. Aerobic training (AT) is established as the cornerstone of primary and secondary disease prevention in multiple clinical settings, and may confer similar benefits in HCT patients at high-risk of CVD. The potential benefits of AT either before, immediately after, or in the months/years following HCT have received limited attention. Here, we discuss the risk and extent of CVD in adult HCT patients, highlight novel tools for early detection of CVD, and review existing evidence in oncology and non-oncology populations supporting the efficacy of AT to attenuate HCT-induced CVD. This knowledge can be utilized to optimize treatment, while minimizing CVD risk in individuals with hematological malignancies undergoing HCT.
authors.affiliation: Universities Space Research Association NASA Johnson Space Center, Houston, TX, USA.
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Scott
authors.affiliation: City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
authors.forename: Saro
authors.initials: S
authors.lastname: Armenian
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Sergio
authors.initials: S
authors.lastname: Giralt
authors.affiliation: Vanderbilt University, Nashville, TN, USA.
authors.forename: Javid
authors.initials: J
authors.lastname: Moslehi
authors.affiliation: Vanderbilt University, Nashville, TN, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wang
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, NY, USA. Electronic address: jonesl3@mskcc.org.
authors.forename: Lee W
authors.initials: LW
authors.lastname: Jones
mesh_terms: D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control; D003324:Coronary Artery Disease / Q000209:etiology; D015444:Exercise; D006333:Heart Failure / Q000209:etiology; D019337:Hematologic Neoplasms / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008019:Life Style
keywords: Cardiovascular disease; Detection; Exercise; Hematopoietic stem cell transplantation