INTRODUCTION: EBMT LEWP set up the following study with the aim lo evaluate the incidence and the risk factors related to cardiac impairment in children longitudinally observed after BMT. PATIENTS AND METHODS: between 1994 and 1997, 176 consecutive patients (median age 9.4 years, 102 males and 74 females) undergoing ABMT (48) and AlloBMT (128) for malignant (155) and non-malignant (21) diseases were enrolled in this study in order to have at least a minimum follow-up of 5 years. Cardiac function was investigated by M-mode echocardiography performed pre-BMT, 6 months after BMT and subsequently yearly. 92 patients received anthracyclines as part of chemotherapy (first or second line), while 99 TBI and/or Cytoxan plus other drugs as conditioning regimen before BMT. The anthracyclines cumulative dose, TBI containing regimen, acute and chronic GVHD, sex, age, have been evaluated as possible risk factors of late cardiac dysfunction. RESULTS: None patient deceased because of cardiac involvement per se. The followup, up to now, is 3 years and thus the below results can change throughout next years. Of the overall series, 29 children (16%) only presented an impairment of the shortening fraction, but only 19/29 survived long enough to be analyzed for the late effects. All the 29 patients were asymptomatic, revealing the cardiac involvement by echocardiography only (16/29 already in the pre-BMT phase). No significative statistical difference has been observed as far the impact of various risk factors analyzed was concerned. However, patients affected by malignancies, given an AlloBMT and presenting c-GVHD seem more prone to develop a cardiac impairment in the long term. CONCLUSIONS: No life-threatening late cardiac complications emerge from our study which points out a relatively high incidence of cardiac involvement (16%) even if asymptomatic. In the wide scenario of a large number of transplanted children potentially cured from the primary disease a longitudinal observation of cardiac late effects seems worthwhile.
|Issue number||11 PART I|
|Publication status||Published - 2000|
ASJC Scopus subject areas