Early Echocardiographic and Serum Biomarkers Predict Thrombotic Microangiopathy, Endotheliopathy, and Survival after Pediatric Hematopoietic Stem Cell Transplant

Among pediatric HSCT recipients, acute cardiovascular injury associated with HSCT-related endotheliopathy develops at a subclinical level in the early post-transplant period. Subtle increases in right and left ventricular function, increases in BNP level, and pericardial effusions likely reflect an early response to endothelial injury and are associated with the later development of TA-TMA, other endotheliopathies, and death. Screening protocols and prophylactic and therapeutic interventions for pediatric HSCT recipients should consider these novel cardiovascular biomarkers.