PMID- 9012933
OWN - NLM
STAT- MEDLINE
DCOM- 19970408
LR  - 20061115
IS  - 0268-3369 (Print)
IS  - 0268-3369 (Linking)
VI  - 19
IP  - 1
DP  - 1997 Jan
TI  - Cardiovascular function in children following bone marrow transplant: a 
      cross-sectional study.
PG  - 61-6
AB  - Sixty-three patients who had undergone a BMT at age < or = 18 years were 
      evaluated cross-sectionally to determine cardiac function as well as the 
      long-term prevalence, types, severity, and risk factors of cardiac abnormalities. 
      Patients were > or = 1 year post-BMT and were evaluated by history, resting ECG, 
      echocardiography (ECHO), exercise treadmill test, chest X-ray, pulmonary function 
      tests and review of past cardiac studies. Patients were assigned a New York Heart 
      Association (NYHA) class based on an activity and cardiac symptoms questionnaire. 
      Pretransplant preparative regimens included high-dose cyclophosphamide (CY) and 
      total body/lymphoid irradiation (n = 38), CY in combination with other 
      chemotherapy (n = 22), and other drug combinations (n = 3). Forty patients 
      (63.5%) had received prior anthracyclines (median 307 mg/m2). Patients' ages 
      ranged from 1.9 to 32 years (median 10.9 years) with median follow-up of 3.3 
      years (range 1-16.3 years). Twenty-six patients (41.3%) had a cardiac abnormality 
      detected at follow-up. In 21 patients the abnormal finding had not been present 
      at the pre-BMT evaluation. Ten patients (16.4%) had resting ECG abnormalities. 
      Left ventricular ejection fraction (LVEF) by ECHO was mildly decreased to 50-54% 
      in three patients and markedly decreased to 40% in one patient. Only one patient 
      (1.7%) developed a mildly abnormal shortening fraction of 27%. All patients with 
      ECHO abnormalities were asymptomatic. Twenty-three of 31 patients > or = 9 years 
      of age (74%) who underwent a treadmill exercise test had a borderline or abnormal 
      response to exercise. There was no correlation between demographic factors, 
      previous therapy, preparative regimen or length of follow-up with the post-BMT 
      ECG, ECHO and treadmill abnormalities. Overall, eight patients (12.7%) were 
      symptomatic and NYHA class II or III, and all had abnormal exercise tests. The 
      presence of symptoms and NYHA class were predictors for oxygen consumption during 
      exercise (P = 0.03 and 0.02, respectively) and tended to predict overall 
      treadmill results also. Late cardiac abnormalities do occur following BMT in 
      childhood and thus, there is a clear need for continued, serial long-term cardiac 
      evaluation in transplant survivors. Evaluations should include exercise stress 
      testing to detect inadequate cardiac output as well as oxygen consumption during 
      exercise.
FAU - Eames, G M
AU  - Eames GM
AD  - Department of Pediatrics, University of Minnesota, School of Medicine, 
      Minneapolis, USA.
FAU - Crosson, J
AU  - Crosson J
FAU - Steinberger, J
AU  - Steinberger J
FAU - Steinbuch, M
AU  - Steinbuch M
FAU - Krabill, K
AU  - Krabill K
FAU - Bass, J
AU  - Bass J
FAU - Ramsay, N K
AU  - Ramsay NK
FAU - Neglia, J P
AU  - Neglia JP
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Bone Marrow Transplant
JT  - Bone marrow transplantation
JID - 8702459
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - *Bone Marrow Transplantation/*adverse effects
MH  - Cardiovascular Diseases/*etiology/physiopathology
MH  - Child
MH  - Child, Preschool
MH  - Cross-Sectional Studies
MH  - Electrocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Infant
MH  - Male
MH  - Prevalence
MH  - Risk Factors
EDAT- 1997/01/01 00:00
MHDA- 1997/01/01 00:01
CRDT- 1997/01/01 00:00
PHST- 1997/01/01 00:00 [pubmed]
PHST- 1997/01/01 00:01 [medline]
PHST- 1997/01/01 00:00 [entrez]
AID - 10.1038/sj.bmt.1700600 [doi]
PST - ppublish
SO  - Bone Marrow Transplant. 1997 Jan;19(1):61-6. doi: 10.1038/sj.bmt.1700600.