Cardiovascular Considerations in Hematopoietic Stem Cell Transplantation (April 19, 2024)_(3031536584)_(Springer)

This book discusses the epidemiology and the known cardiotoxic effects of chemoradiation agents in addition to newer therapies in hematopoietic stem cell transplantation (HSCT). Recent expert consensus statements from cardiology and hematology/oncology societies are reviewed in regard to risk stratification of the patient based on the type of treatments they are undergoing. Finally, gaps in knowledge are identified with proposed avenues of research that allow for more accurate risk assessment, prediction and potential treatment of the HSCT patient in attenuating the risk of developing cardiovascular comorbidities. Cardiovascular Considerations in Hematopoietic Stem Cell Transplantation reveals a picture of effective management of these patients in order to optimize both short- and long-term outcomes of HSCT. It is of considerable interest to all involved or training within this rapidly growing area of cardiology and oncology. Contents HSCT at a Glance 1 An Overview of Hematopoietic Stem Cell Transplantation 2 Conditioning Regimens 3 Donor Types and Human Leukocyte Antigen (HLA) Matching in Allogeneic HSCT 4 Stem Cell Collection 5 History of Stem Cell Transplantation in Iran References Burden of Cardiovascular Disease in HSCT 1 Introduction 2 Cardiovascular Disease in Post HSCT Patients 2.1 Cardiovascular Risk Factors in HSCT Survivors 2.2 Cardiovascular Disease 2.3 Heart Failure 2.4 Arrhythmia 2.5 Pericardial Disease 3 Conclusion and Future Horizon References Risk Factors and Mechanisms of Cardiotoxicity in HSCT 1 History of Cardiotoxic Therapies 1.1 Anthracyclines 1.2 Chest Radiation 1.3 Cyclophosphamide 2 Graft Versus Host Disease (GvHD) 3 Cardiovascular Comorbidities and Risk Factors 4 Clonal Hematopoiesis of Indeterminate Potential (CHIP) 5 Functional Disability References Cardiotoxicity of Commonly Used Drugs in HSCT 1 Introduction References Pre-HSCT Cardiovascular Evaluation 1 Introduction 2 Cardiovascular Complications Associated with HSCT 2.1 Short-Term Cardiotoxicity during HSCT 2.2 Long-Term Cardiac Complications from HSCT 3 Biochemical and Electrocardiographic Parameters 4 Lifestyle Modifications 5 Electrocardiogram Screening 6 Cardiac Imaging in Survivors 7 Drugs with Cardio-Toxicity 8 Baseline Cardiovascular Risk Stratification Proforma References Long Term Cardiotoxicity Surveillance in HSCT 1 Introduction 2 Cardiotoxicity in Long-Term Survivors 3 Cardiovascular Consequences After HSCT 4 Vascular Diseases 5 Heart Failure 6 Metabolic Syndrome 7 Factors Impacting Incidence of Cardiotoxicity 8 Endothelial Injury to Cardiovascular Disease 9 Screening 9.1 Screening of the Modifiable Cardiovascular Risk Factors 10 Detecting Cardiac Injury 11 Cancer Survivorship Clinics 12 Management 12.1 Management of Cardiovascular Risk Factors 12.2 Cardiomyopathy 13 Conclusion and Future Perspective References Cardiac Manifestations of Graft-Versus-Host Disease 1 Introduction 2 GVHD 3 Cardiac GVHD 3.1 Cardiac GVHD Epidemiology 3.2 Cardiac GVHD Mechanisms 3.3 Cardiac GVHD Manifestation 4 Cardiovascular Disease Screening 5 Conclusion and Future Horizons References HSCT in Low EF Patients 1 Hematopoietic Stem Cells Transplantation, Chemotherapy-Induced Cardiotoxicity and Radiation-Induced Cardiovascular Disease 2 Clinical Management of Patients with Reduced Left Ventricular Ejection Fraction Undergoing Hematopoietic Cell Transplantation 3 HCT in Patients Who Have Already Reduced LVEF Prior to the HCT 3.1 Practical Points (Lehmann et al. 2000; Gavriilaki et al. 2019; Zhao et al. 2022; Qazilbash et al. 2009; Piranfar et al. 2012; Mo et al. 2013; Hurley et al. 2015; Moriyama et al. 2022; Lyon et al. 2022) 3.2 Management of LV Dysfunction During or After HCT(Lehmann et al. 2000; Gavriilaki et al. 2019; Zhao et al. 2022; Qazilbash et al. 2009; Mo et al. 2013; Hurley et al. 2015; Moriyama et al. 2022) 4 Recommendations 5 Conclusion References Hypertension in HSCT 1 Introduction 2 Risk Factors for the Development of Hypertension in HSCT 3 Complications of HSCT Associated with HTN 4 Screening, Evaluation, and Treatment of HTN in HSCT 5 Lifestyle Modifications 6 Pharmacological Treatment 7 Conclusion and Future Perspective References Diabetes Mellitus in HSCT 1 Introduction 2 Impact of Hyperglycemia in HSCT Recipients 3 Post-transplant Diabetes Mellitus (PTDM) in the Context of HSCT 3.1 Definition and Prevalence 3.2 Pathogenesis 3.3 Prevention and Treatment and Long-Term Follow-Up of PTMD 3.4 The Role of HCST in Treatment of Type 1 Diabetes Mellitus 3.5 The Role of HCST in Treatment of Type 2 Diabetes Mellitus 4 Future Directions and Conclusion References Arrhythmias and Conduction Disorders in HSCT 1 Introduction 1.1 Arrhythmia 1.2 Classes of Chemotherapy Drugs and Arrhythmias 1.3 Alkylating Agent Drugs 1.4 Proteasome Inhibitors 1.5 “Bradyarrhythmic Syndrome in HSCT Patients” 2 Conclusion References Coronary Artery Disease in HSCT 1 Coronary Artery Disease 1.1 Definition 1.2 Diagnosis 1.3 Symptoms 1.4 Epidemiology 1.5 Etiology and Risk Factors 2 Treatment References Peripheral Arterial Disease in HSCT References Thrombotic Disease in Thrombosis in Hematopoietic Stem Cell Transplantation (HSCT) Recipients 1 Highlights 2 Epidemiology 3 Diagnosis 4 Treatment 5 CRT 6 VTE Prophylaxis References Pulmonary Hypertension in HSCT 1 Definition 2 Epidemiology 3 Hemodynamics and Classification of PH 3.1 Pathophysiology 3.2 Etiology and Risk Factors 4 Clinical Presentation 5 Diagnosis 6 Clinical Management Strategies and Treatment References Pericardial Disease in HSCT 1 Pericardial Effusion 1.1 Definition 1.2 Diagnosis 1.3 Symptoms 1.4 Epidemiology 1.5 Etiology and Risk Factors 1.6 Treatment 2 Pericarditis 2.1 Definition 2.2 Diagnosis 2.3 Symptoms 2.4 Epidemiology 2.5 Etiology and Risk Factors 2.6 Treatment 3 Constrictive Pericarditis 3.1 Definition 3.2 Diagnosis 3.3 Symptoms 3.4 Etiology and Risk Factors 3.5 Treatment 4 Effusive-Constrictive Pericarditis References Metabolic Syndrome in HSCT 1 Introduction 2 Epidemiology and Importance of Metabolic Syndrome After HSCT 3 Pathogenesis 4 Prevention, Treatment, and Management of Metabolic Syndrome Component After HSCT References HSCT in Patients with Cardiac Amyloidosis 1 Introduction 2 Types of Cardiac Amyloidosis 3 Epidemiology 4 Clinical Manifestation (When to Suspect) 5 Diagnostic Evaluation 6 ECG 7 Echocardiography 8 Cardiac Magnetic Resonance Imaging 9 Nuclear Imaging 10 Cardiac CT 11 Cardiac Biomarkers 12 Monoclonal Protein 13 Tissue Biopsy 14 Chromosomal Changes 15 Prognosis 16 Other Organs Involvement Evaluation 17 Treatment 18 Cardiac Failure 19 Arrhythmia 20 Anticoagulation 21 Device Therapy 22 Treatment of Al-Amyloidosis 23 Patients Eligible for Transplant 24 Patients Ineligible for Transplant 25 Relapsed/refractory Patients 26 Survival of Patients References HSCT in Patients with Hemoglobinopathies 1 An Introduction to Hemoglobinopathies 2 Stem Cell Transplantation for Hemoglobinopathies 3 Cardiac Complications in Hemohlobinopathies 3.1 Underlying Disease Associated Cardiac Complications 3.2 Transplant-Related Cardiac Complications Rehabilitation in HSCT 1 Rehabilitation Approach for HSCT 1.1 Rehabilitation Evaluation Assessment 1.2 Development of Individualized Rehabilitation Plans 1.3 Patient Education on the Transplant Process and Potential Complications 1.4 Preparation for Physical Therapy and Exercise 2 Post-transplantation Rehabilitation 2.1 Timing of Rehabilitation Interventions 2.2 Rehabilitation Phases in HSCT 2.3 Management of Physical and Emotional Symptoms Such as Fatigue, Pain, and Weakness 2.4 Monitoring and Management of GVHD 2.5 Mental Health Support for Patients and Caregivers 2.6 Nutritional Support and Management of Gastrointestinal Symptoms 2.7 Pulmonary Rehabilitation for Patients with Lung Complications 2.8 Incorporation of Complementary and Alternative Medical Therapies 2.9 The Multidisciplinary Approach to Rehabilitation 3 Economic Considerations and Insurance Coverage 4 Conclusion References Index