Cardiac Events Occurring after Allogeneic Hematopoietic Cell Transplantation with Post-Transplant Cyclophosphamide. Study Conducted on Behalf of the GETH-TC

Abstract

This multicenter study investigates the incidence and predictors of cardiac events (CE) following allo-HCT with PTCY in 453 AML patients. CE occurred in 67 (14.3%) patients within a median of 81 days (IQR: 13-380), with day 100 and 5-year cumulative incidences of 8.2% and 15.3%. Early (first 100 days) and late CE occurred at rates of 8.2% and 6.2%. The most prevalent CE were heart failure (n=21, 32.8%), arrhythmia (n=17, 26.6%), and pericardial complications (n=16, 25%). The proportions of patients older than 50 years (73.4% vs. 59.4%, P=0.032), with hypertension (34.9% vs. 18.3%, P=0.001), dyslipidemia (26.6% vs. 11.1%, P=0.001), and undergoing haplo-HCT (70.3% vs. 55.8%, P=0.029) were higher in patients with CE. However, the multivariate regression analysis revealed that only hypertension (HR 2.02, P=0.015) and dyslipidemia (HR 2.20, P=0.015) were predictors for CE, with no differences according to donor type (haplo-HCT vs. others: HR 1.49, P=0.151). Among the 64 patients with CE, the mortality rate was 10.9%. Notably, the diagnosis of CE negatively impacted NRM (HR 2.40, P=0.013) and OS (HR 1.79, P=0.014), underscoring necessity of aggressively treating cardiovascular risk factors, and implementing post-transplant cardiac monitoring protocols to prevent these complications.