Image: Researchers develop new risk score for cardiovascular complications after bone marrow transplant (Photo credit: 123RF)

Every year, thousands of people undergo bone marrow transplants for the potential cure of serious diseases such as leukemia, lymphoma, and immunodeficiency diseases. Although these transplants can potentially save lives, they also pose risks to various organs, including the heart and blood vessels. Advances in medical science have made these transplants available to older adults who are at higher risk for cardiovascular disease. Now, researchers have identified the current incidence of heart-related complications after bone marrow transplants and created a new tool to predict an individual’s risk for such problems and guide the pre-transplant process. Did.

Researchers led by the Michigan Medical Society in Ann Arbor, Mich., have created a cardiovascular registry in bone marrow transplantation, known as CARE-BMT, that compiles data on patients who have undergone transplants. Their study, which looked at more than 3,300 patients from 2008 to 2019, found that 4.1% experienced a cardiovascular event within 100 days after transplantation, and 13.9% experienced such an event within 5 years. There was found. Cardiovascular problems during hospitalization were rare, but the most frequent long-term symptoms were atrial fibrillation, present in 6.8% of patients and 5.4% of patients by 5 years. I had heart failure. Serious complications such as heart attacks and strokes were rare.

The study found that 16.4% of patients who received bone marrow from a donor faced a long-term cardiovascular event within five years, compared to 12.1% of patients who received their own stem cells. People with heart conditions such as diabetes or coronary artery disease are more likely to experience long-term complications, although not during the transplant. Researchers used CARE-BMT data to determine whether or not the patient was diagnosed based on readily available clinical information, such as age, race, history of coronary artery disease or heart failure, and past exposure to heart-damaging chemotherapy. We devised a simple point-based risk score. This risk score, called the CARE-BMT risk score, allowed us to identify a high-risk group that made up more than 30% of the study participants. In this group, the incidence of cardiovascular complications increased from 31.9% at 5 years to 55% at 10 years. This score is effective in predicting risk for both donors and autologous bone marrow transplant recipients and was validated in a separate group of over 900 patients.

“In the early days of bone marrow transplantation, cardiac patients were often excluded due to the cardiotoxicity of the conditioning therapies used at the time,” said Dr. Professor Salim Hayek, MD, says: in cardio-oncology. “Understanding the cardiovascular risks of modern bone marrow transplantation is critical to selecting appropriate patients and ensuring that no patients are excluded unnecessarily. , the first modern evidence of how to assess a patient’s risk for cardiovascular complications, which together can guide clinicians to ensure better outcomes with this procedure. ”

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