Cardiovascular Disease After Hematopoietic Stem Cell Transplantation in Adults
David Gent, Muhammad Wasif Saif, Rebecca Dobson, David J. Wright
Abstract
The use of hematopoietic cell transplantation (HCT) has expanded in the last 4 decades to include an older and more comorbid population. These patients face an increased risk of cardiovascular disease after HCT. The risk varies depending on several factors, including the type of transplant (autologous or allogeneic). Many therapies used in HCT have the potential to be cardiotoxic. Cardiovascular complications after HCT include atrial arrhythmias, heart failure, myocardial infarction, and pericardial effusions. Before HCT, patients should undergo a comprehensive cardiovascular assessment, with ongoing surveillance tailored to their individual level of cardiovascular risk. In this review, we provide an overview of cardiotoxicity after HCT and outline our approach to risk assessment and ongoing care. • HCT is associated with adverse cardiovascular outcomes. • Patients should have cardiovascular comorbidities optimized before HCT. • Ongoing surveillance should be tailored to the individual’s cardiovascular risk. • Future research should focus on the validation of cardiovascular risk prediction tools, screening, and surveillance strategies.