Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Post-Transplant Events

Clinical outcomes of patients with impaired left ventricular ejection fraction undergoing autologous bone marrow transplantation: can we safely transplant patients with impaired ejection fraction?

Summary:

Experience with autologous bone marrow transplantation (ABMT) in patients with impaired left ventricular ejection fraction (LVEF) or heart failure (HF) is limited. We identified 308 consecutive patients who underwent ABMT for Hodgkin's or non-Hodgkin's lymphoma at our institution (1996–2003). Patient characteristics, clinical course and overall survival were compared between patients with preserved (50%) or impaired (<50%) LVEF. Of the 308 patients identified, 20 had baseline impaired LVEF (four with LVEF 40%, all NYHA class I–II HF). None of the patients with post-ABMT echocardiogram had worsened LVEF (n=7). Among the 20 patients with impaired LVEF, four patients had reversible cardiac complications post-ABMT (including worsening HF). The two deaths observed in the impaired LVEF group were both due to noncardiac causes. The 5-year survival was similar between patients with preserved and impaired LVEF (P=0.43). Careful selection of patients with stable, mild-to-moderate HF and impaired LVEF for ABMT can achieve similar long-term survival. As medical care for HF and ABMT improves, the exclusion criteria for ABMT with regard to HF and impaired LVEF should be re-examined.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Buja LM, Ferrans VJ, Graw RGJ . Cardiac pathologic findings in patients treated with bone marrow transplantation. Hum Pathol 1976; 7: 17–45.

    Article  CAS  Google Scholar 

  2. Kupari M, Volin L, Suokas A et al. Cardiac involvement in bone marrow transplantation: electrocardiographic changes, arrhythmias, heart failure and autopsy findings. Bone Marrow Transplant 1990; 5: 91–98.

    CAS  Google Scholar 

  3. Cazin B, Gorin NC, Laporte JP et al. Cardiac complications after bone marrow transplantation: a report on a series of 63 consecutive transplantations. Cancer 1986; 57: 2061–2069.

    Article  CAS  Google Scholar 

  4. Murdych T, Weisdorf DJ . Serious cardiac complications during bone marrow transplantation at the University of Minnesota, 1977–1997. Bone Marrow Transplant 2001; 28: 283–287.

    Article  CAS  Google Scholar 

  5. Fujimaki K, Maruta A, Yoshida M et al. Severe cardiac toxicity in hematological stem cell transplantation: predictive value of reduced left ventricular ejection fraction. Bone Marrow Transplant 2001; 27: 307–310.

    Article  CAS  Google Scholar 

  6. Lehmann S, Isberg B, Ljungman P et al. Cardiac systolic function before and after hematopoietic stem cell transplantation. Bone Marrow Transplant 2000; 26: 187–192.

    Article  CAS  Google Scholar 

  7. Bolwell BJ . Are predictive factors clinically useful in bone marrow transplantation? Bone Marrow Transplant 2003; 32: 853–861.

    Article  CAS  Google Scholar 

  8. Bearman SI, Petersen FB, Schor RA . Radionuclide ejection fractions in the evaluation of patients being considered for bone marrow transplantation: risk for cardiac toxicity. Bone Marrow Transplant 1990; 5: 173–177.

    CAS  Google Scholar 

  9. Hetenstein B, Stefanic M, Schmeiser T . Cardiac toxicity of bone marrow transplantation: predictive value of cardiologic evaluation before transplant. J Clin Oncol 1994; 12: 998–1004.

    Article  Google Scholar 

  10. Jain B, Floreani AA, Anderson JR . Cardiopulmonary function and autologous bone marrow transplantation: results and predictive value for respiratory failure and mortality. Bone Marrow Transplant 1996; 17: 561–568.

    CAS  Google Scholar 

  11. Zangari M, Henzlova MJ, Ahmad S . Cardiopulmonary function and autologous bone marrow transplantation: results and predictive value for respiratory failure and mortality. Bone Marrow Transplant 1999; 23: 917–920.

    Article  CAS  Google Scholar 

  12. Goldberg SL, Klumpp TR, Magdalinski AJ et al. Value of the pretransplant evaluation in predicting toxic day-100 mortality among blood stem-cell and bone marrow transplant recipients. J Clin Oncol 1998; 16: 3796–3802.

    Article  CAS  Google Scholar 

  13. Brockstein BE, Smiley C, Al-Sadir J et al. Cardiac and pulmonary toxicity in patients undergoing high-dose chemotherapy for lymphoma and breast cancer: prognostic factors. Bone Marrow Transplant 2000; 25: 885–894.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to B J Bolwell.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tang, W., Thomas, S., Kalaycio, M. et al. Clinical outcomes of patients with impaired left ventricular ejection fraction undergoing autologous bone marrow transplantation: can we safely transplant patients with impaired ejection fraction?. Bone Marrow Transplant 34, 603–607 (2004). https://doi.org/10.1038/sj.bmt.1704610

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1704610

Keywords

This article is cited by

Search

Quick links