TY - JOUR
T1 - Clinical outcomes of patients with impaired left ventricular ejection fraction undergoing autologous bone marrow transplantation
T2 - Can we safely transplant patients with impaired ejection fraction?
AU - Tang, W. H.W.
AU - Thomas, S.
AU - Kalaycio, M.
AU - Sobecks, R.
AU - Andresen, S.
AU - Jarvis, S.
AU - Rybicki, L.
AU - Pohlman, B.
AU - Francis, G. S.
AU - Bolwell, B. J.
PY - 2004/10
Y1 - 2004/10
N2 - 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.
AB - 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.
KW - Autologous stem cell transplantation
KW - Hodgkin's disease
KW - Left ventricular ejection fraction
KW - Non-Hodgkin's lymphoma
UR - http://www.scopus.com/inward/record.url?scp=5044247611&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=5044247611&partnerID=8YFLogxK
U2 - 10.1038/sj.bmt.1704610
DO - 10.1038/sj.bmt.1704610
M3 - Article
C2 - 15258558
AN - SCOPUS:5044247611
SN - 0268-3369
VL - 34
SP - 603
EP - 607
JO - Bone marrow transplantation
JF - Bone marrow transplantation
IS - 7
ER -