Bone marrow transplantation conditioning transiently increased left ventricular mass index at 1 month (85.1 vs 76.1 g/m2; P<0.001) and impaired function, which reversed by 1 year.
Cohort (n=45)
Does bone marrow transplantation conditioning with cyclophosphamide and total body irradiation cause changes in left ventricular size, mass, and performance in adult patients with haematological malignancies?
Conditioning with cyclophosphamide and total body irradiation for bone marrow transplantation causes subclinical, reversible impairment of left ventricular function and increased mass at 1 month that resolves by 1 year.
Absolute Event Rate: 85.1% vs 76.1%
p-value: p=<0.001
Forty-five consecutive adult patients with haematological malignancies were studied prospectively to evaluate cardiac involvement in bone marrow transplantation (BMT). Echocardiography and measurement of systolic time intervals were performed before conditioning with cyclophosphamide (CY) (120 mg kg-1) and total body irradiation (10-12 Gy), and repeated 1 month and 1 year after BMT. The left ventricular (LV) changes at the 1-month study included increases in mass index (85.1 +/- 4.0 g m-2 vs: 76.1 +/- 3.3 g m-2, mean +/- SE; P less than 0.001) and in the pre-ejection period/ejection time ratio (0.46 +/- 0.01 vs. 0.36 +/- 0.01, P less than 0.001), and decreases in fractional shortening (24.9 +/- 1.0% vs. 27.9 +/- 0.8%, P less than 0.01) and in the peak normalized diameter lengthening rate (2.2 +/- 0.1 s-1 vs. 2.6 +/- 0.1 s-1, P less than 0.01). Four patients developed congestive heart failure. Twenty-four patients were alive and relapse-free 1 year after BMT. The LV measurements were then no longer different from the pre-transplant readings. Thus BMT that is preceded by conditioning with CY and total body irradiation results in increased LV mass and impaired systolic and diastolic LV function. These changes are mostly subclinical, and are also reversible if the recipient survives the initial months after transplantation.
Kupari et al. (Sun,) conducted a cohort in Haematological malignancies (n=45). Bone marrow transplantation conditioning with cyclophosphamide and total body irradiation vs. Baseline (pre-transplant) was evaluated on Left ventricular mass index at 1 month (g/m2) (p=<0.001). Bone marrow transplantation conditioning transiently increased left ventricular mass index at 1 month (85.1 vs 76.1 g/m2; P<0.001) and impaired function, which reversed by 1 year.