European journal of preventive cardiology · 2026
Predicting cardiovascular events in allogeneic haematopoietic stem cell transplant recipients.
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Sibilia Benjamin, Gonçalves Trecy, Chevillon Florian, Zhao Lin Pierre, Benayoun Michael, Baudet Mathilde, Toupin Solenn, Dhedin Nathalie, Boissel Nicolas, Singh Manveer, Unger Alexandre, Sicre de Fontbrune Flore, Michonneau David, Xhaard Aliénor, Peffault de Latour Régis, Logeart Damien, Cohen Solal Alain, Azibani Fériel, Dillinger Jean-Guillaume, Henry Patrick, Robin Marie, Pezel Théo
Аннотация
AIMS: Patients undergoing allogeneic haematopoietic stem cell transplantation (alloHSCT) are at increased risk of cardiovascular complications; however, comprehensive data on these risks in large cohorts remain limited. This study aims to identify predictors of cardiovascular events in a large cohort of alloHSCT patients.
METHODS AND RESULTS: We conducted a retrospective monocentric study including all consecutive patients aged 15 years and older with haematologic malignancies who underwent alloHSCT between 2011 and 2020. Data were extracted from electronic medical records, including demographic, clinical, and transplant-specific variables. The primary composite outcome was cardiotoxicity including cardiovascular death, heart failure (HF), rhythm/conduction disorders, acute arterial events, venous thromboembolism (VTE), and myopericarditis. Predictors of cardiotoxicity were analysed using Cox proportional hazards regression and Fine-and-Gray models. Among 1027 patients recruited (age 45 ± 16 years, 62% male), 30% experienced cardiotoxicity after a median (interquartile range, IQR) follow-up of 4 (1-7) years. The median (IQR) time to the first event was 8 months (3-17). In multivariable analysis, independent predictors for early events (≤100 days) were age, hypertension, history of HF, cancer therapy-related cardiac dysfunction (CTRCD), and high-dose administration of cyclophosphamide (≥100 mg/kg). For late events (>100 days), independent predictors were age, hypertension, history of VTE, atrial fibrillation/flutter, history of HF, CTRCD, previous liposomal anthracycline exposure, and high-risk haematopoietic cell transplantation-comorbidity index (HCT-CI) score category.
CONCLUSION: Our study identifies independent predictors of early and late cardiotoxicity, including demographic data, cardiovascular risk factors, history of cardiovascular disease, and oncologic history.
REGISTRATION: EBMT registry: CNIL 2093819.
METHODS AND RESULTS: We conducted a retrospective monocentric study including all consecutive patients aged 15 years and older with haematologic malignancies who underwent alloHSCT between 2011 and 2020. Data were extracted from electronic medical records, including demographic, clinical, and transplant-specific variables. The primary composite outcome was cardiotoxicity including cardiovascular death, heart failure (HF), rhythm/conduction disorders, acute arterial events, venous thromboembolism (VTE), and myopericarditis. Predictors of cardiotoxicity were analysed using Cox proportional hazards regression and Fine-and-Gray models. Among 1027 patients recruited (age 45 ± 16 years, 62% male), 30% experienced cardiotoxicity after a median (interquartile range, IQR) follow-up of 4 (1-7) years. The median (IQR) time to the first event was 8 months (3-17). In multivariable analysis, independent predictors for early events (≤100 days) were age, hypertension, history of HF, cancer therapy-related cardiac dysfunction (CTRCD), and high-dose administration of cyclophosphamide (≥100 mg/kg). For late events (>100 days), independent predictors were age, hypertension, history of VTE, atrial fibrillation/flutter, history of HF, CTRCD, previous liposomal anthracycline exposure, and high-risk haematopoietic cell transplantation-comorbidity index (HCT-CI) score category.
CONCLUSION: Our study identifies independent predictors of early and late cardiotoxicity, including demographic data, cardiovascular risk factors, history of cardiovascular disease, and oncologic history.
REGISTRATION: EBMT registry: CNIL 2093819.