Induction Chemotherapy‐Related Covert Cardiac Remodeling in Pre‐Autologous Hematopoietic Stem Cell Transplantation for Multiple Myeloma: A Retrospective Observational Study
ABSTRACT Background Autologous hematopoietic stem cell transplantation (ASCT) has emerged as a cornerstone in multiple myeloma (MM) management, offering the prospect of prolonged disease control. However, the induction chemotherapy drugs required prior to ASCT carry cardiovascular toxicity (CVT), po...
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2024-11-01
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| Online Access: | https://doi.org/10.1002/cam4.70329 |
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| author | Chang Dai Weidong Lin Fangzhou Liu Xin Chen Yuhan Chen Yu Jiang Jiaojiao Bai Yidong Lv Jianhong Zheng Hai Deng Xin Du Shulin Wu Yumei Xue |
| author_facet | Chang Dai Weidong Lin Fangzhou Liu Xin Chen Yuhan Chen Yu Jiang Jiaojiao Bai Yidong Lv Jianhong Zheng Hai Deng Xin Du Shulin Wu Yumei Xue |
| author_sort | Chang Dai |
| collection | DOAJ |
| description | ABSTRACT Background Autologous hematopoietic stem cell transplantation (ASCT) has emerged as a cornerstone in multiple myeloma (MM) management, offering the prospect of prolonged disease control. However, the induction chemotherapy drugs required prior to ASCT carry cardiovascular toxicity (CVT), potentially leading to a range of cardiovascular complications. Methods and Results This retrospective observational study, conducted at Guangdong Provincial People's Hospital from January 2020 to December 2023, analyzed 47 of the initial 173 patients who met the criteria. The cohort, comprising 22 males (46.81%) and 25 females (53.19%), had a mean age of 55.68 ± 11.38 years. They underwent various induction chemotherapy regimens, receiving a median of 5 (4–6) cycles of the course over an average duration of 7.10 ± 2.46 months. Before ASCT treatment following induction chemotherapy, echocardiographic findings indicated reductions in left ventricular end‐systolic dimension, right atrial diameter, E‐wave velocity, E/e' ratio, and the E/A ratio. The latter altered from a pretreatment value greater than 1 to posttreatment less than 1, marking diastolic dysfunction emergence or aggravation in 51.06% of patients. The electrocardiographic data indicate a reduced heart rate and prolonged P‐wave duration and P‐R duration, with an increase in arrhythmia incidence to 19.15% following induction chemotherapy. Conclusion Induction chemotherapy, administered prior to ASCT in patients with MM, can lead to the emergence or aggravation of cardiac diastolic dysfunction and increase the incidence of arrhythmic events. Therefore, it is crucial to emphasize the importance of balancing the benefits and risks of induction chemotherapy to maximize its efficacy while minimizing CVT. |
| format | Article |
| id | doaj-art-abd910b1444b485bb914f894fd62f321 |
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| language | English |
| publishDate | 2024-11-01 |
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| series | Cancer Medicine |
| spelling | doaj-art-abd910b1444b485bb914f894fd62f3212025-08-20T02:14:39ZengWileyCancer Medicine2045-76342024-11-011321n/an/a10.1002/cam4.70329Induction Chemotherapy‐Related Covert Cardiac Remodeling in Pre‐Autologous Hematopoietic Stem Cell Transplantation for Multiple Myeloma: A Retrospective Observational StudyChang Dai0Weidong Lin1Fangzhou Liu2Xin Chen3Yuhan Chen4Yu Jiang5Jiaojiao Bai6Yidong Lv7Jianhong Zheng8Hai Deng9Xin Du10Shulin Wu11Yumei Xue12Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences) Southern Medical University Guangzhou Guangdong P.R. ChinaDepartment of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences) Southern Medical University Guangzhou Guangdong P.R. ChinaDepartment of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences) Southern Medical University Guangzhou Guangdong P.R. ChinaDepartment of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences) Southern Medical University Guangzhou Guangdong P.R. ChinaDepartment of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences) Southern Medical University Guangzhou Guangdong P.R. ChinaDepartment of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences) Southern Medical University Guangzhou Guangdong P.R. ChinaDepartment of Haematology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences) Southern Medical University Guangzhou Guangdong P.R. ChinaDepartment of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences) Southern Medical University Guangzhou Guangdong P.R. ChinaDepartment of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences) Southern Medical University Guangzhou Guangdong P.R. ChinaDepartment of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences) Southern Medical University Guangzhou Guangdong P.R. ChinaDepartment of Haematology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences) Southern Medical University Guangzhou Guangdong P.R. ChinaDepartment of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences) Southern Medical University Guangzhou Guangdong P.R. ChinaDepartment of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences) Southern Medical University Guangzhou Guangdong P.R. ChinaABSTRACT Background Autologous hematopoietic stem cell transplantation (ASCT) has emerged as a cornerstone in multiple myeloma (MM) management, offering the prospect of prolonged disease control. However, the induction chemotherapy drugs required prior to ASCT carry cardiovascular toxicity (CVT), potentially leading to a range of cardiovascular complications. Methods and Results This retrospective observational study, conducted at Guangdong Provincial People's Hospital from January 2020 to December 2023, analyzed 47 of the initial 173 patients who met the criteria. The cohort, comprising 22 males (46.81%) and 25 females (53.19%), had a mean age of 55.68 ± 11.38 years. They underwent various induction chemotherapy regimens, receiving a median of 5 (4–6) cycles of the course over an average duration of 7.10 ± 2.46 months. Before ASCT treatment following induction chemotherapy, echocardiographic findings indicated reductions in left ventricular end‐systolic dimension, right atrial diameter, E‐wave velocity, E/e' ratio, and the E/A ratio. The latter altered from a pretreatment value greater than 1 to posttreatment less than 1, marking diastolic dysfunction emergence or aggravation in 51.06% of patients. The electrocardiographic data indicate a reduced heart rate and prolonged P‐wave duration and P‐R duration, with an increase in arrhythmia incidence to 19.15% following induction chemotherapy. Conclusion Induction chemotherapy, administered prior to ASCT in patients with MM, can lead to the emergence or aggravation of cardiac diastolic dysfunction and increase the incidence of arrhythmic events. Therefore, it is crucial to emphasize the importance of balancing the benefits and risks of induction chemotherapy to maximize its efficacy while minimizing CVT.https://doi.org/10.1002/cam4.70329arrhythmiaautologous stem cell transplantationcardiovascular toxicityinduction chemotherapymultiple myeloma |
| spellingShingle | Chang Dai Weidong Lin Fangzhou Liu Xin Chen Yuhan Chen Yu Jiang Jiaojiao Bai Yidong Lv Jianhong Zheng Hai Deng Xin Du Shulin Wu Yumei Xue Induction Chemotherapy‐Related Covert Cardiac Remodeling in Pre‐Autologous Hematopoietic Stem Cell Transplantation for Multiple Myeloma: A Retrospective Observational Study Cancer Medicine arrhythmia autologous stem cell transplantation cardiovascular toxicity induction chemotherapy multiple myeloma |
| title | Induction Chemotherapy‐Related Covert Cardiac Remodeling in Pre‐Autologous Hematopoietic Stem Cell Transplantation for Multiple Myeloma: A Retrospective Observational Study |
| title_full | Induction Chemotherapy‐Related Covert Cardiac Remodeling in Pre‐Autologous Hematopoietic Stem Cell Transplantation for Multiple Myeloma: A Retrospective Observational Study |
| title_fullStr | Induction Chemotherapy‐Related Covert Cardiac Remodeling in Pre‐Autologous Hematopoietic Stem Cell Transplantation for Multiple Myeloma: A Retrospective Observational Study |
| title_full_unstemmed | Induction Chemotherapy‐Related Covert Cardiac Remodeling in Pre‐Autologous Hematopoietic Stem Cell Transplantation for Multiple Myeloma: A Retrospective Observational Study |
| title_short | Induction Chemotherapy‐Related Covert Cardiac Remodeling in Pre‐Autologous Hematopoietic Stem Cell Transplantation for Multiple Myeloma: A Retrospective Observational Study |
| title_sort | induction chemotherapy related covert cardiac remodeling in pre autologous hematopoietic stem cell transplantation for multiple myeloma a retrospective observational study |
| topic | arrhythmia autologous stem cell transplantation cardiovascular toxicity induction chemotherapy multiple myeloma |
| url | https://doi.org/10.1002/cam4.70329 |
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