title: Allogeneic peripheral blood stem cell transplantation and accelerated atherosclerosis: An intriguing association needing targeted surveillance. Lessons from a rare case of acute anterior myocardial infarction.
abstract: We report the case of a 23-year-old man who developed an acute ST-elevation myocardial infarction secondary to acute thrombotic occlusion of the proximal left anterior descending coronary artery five years after undergoing chemotherapy, radiotherapy, haematopoietic stem cell transplantation for acute lymphoblastic leukaemia and bulky mediastinal mass involving the pleura and pericardium. His medical history also included Graft versus Host Disease developed 13 months after transplantation and acute myocarditis three months before the actual hospital admission. To the best of our knowledge, coronary artery disease as a complication of haematopoietic stem cell transplantation and low-dose mediastinal radiation therapy in young patients has been rarely reported in the medical literature. Clinicians should have a high degree of suspicion of coronary artery disease in patients treated with allogeneic haematopoietic stem cell transplantation, especially in patients previously treated with target mediastinal radiotherapy, as a group at risk of premature and significantly accelerated atherosclerosis, in order to make a timely and correct diagnosis.
authors.affiliation: Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Scudiero
authors.affiliation: De Gasperis Cardio Centre, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Soriano
authors.affiliation: De Gasperis Cardio Centre, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Nuccia
authors.initials: N
authors.lastname: Morici
authors.affiliation: Haematological Division, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Grillo
authors.affiliation: De Gasperis Cardio Centre, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Oriana
authors.initials: O
authors.lastname: Belli
authors.affiliation: De Gasperis Cardio Centre, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Alice
authors.initials: A
authors.lastname: Sacco
authors.affiliation: De Gasperis Cardio Centre, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Manlio
authors.initials: M
authors.lastname: Cipriani
authors.affiliation: De Gasperis Cardio Centre, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Pedrotti
authors.affiliation: De Gasperis Cardio Centre, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Quattrocchi
authors.affiliation: De Gasperis Cardio Centre, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Silvio
authors.initials: S
authors.lastname: Klugmann
authors.affiliation: De Gasperis Cardio Centre, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Oliva
mesh_terms: D050197:Atherosclerosis / Q000150:complications* / Q000175:diagnosis; D017023:Coronary Angiography; D004562:Electrocardiography; D006801:Humans; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000601:surgery*; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis / Q000209:etiology*; D055815:Young Adult
keywords: Blood-transplantation; Graft versus Host Disease; cardiovascular risk factors; chemotherapy; coronary artery disease; radiation therapy