Abstract
The aim of the study was to examine endothelial function in patients with hematological malignancies treated with high-dose chemotherapy followed by hematopoietic stem cell transplantation. The studies were conducted on 43 consecutive patients qualified for HSCT following high-dose chemotherapy based on the current standards. Then, due to exclusion criteria, a group of 38 patients were chosen for further investigations. Evaluation of endothelial function by means of flow-mediated dilatation (FMD) was conducted in patients with hematological malignancies before HSCT (test A) and after HSCT (test B). Brachial artery diameter (BAD) after occlusion, change in BAD and FMD were significantly lower after HSCT as compared to the results obtained before the transplantation (p < 0.05). The regression analysis indicated that administration of fludarabine and cytarabine, and also higher blood concentrations of creatinine represented risk factors for the impairment of endothelial function expressed as decreased FMD value. In patients with hematopoietic malignancies treated with HSCT, endothelial function assessed by the flow-mediated dilatation was impaired after chemotherapy and stem cell administration.
Highlights
Hematopoietic stem cell transplantation (HSCT) is an important therapeutic strategy in many hematologic malignancies and significantly prolongs survival in patients
Brachial artery diameter (BAD) after occlusion, change in BAD and flow-mediated dilatation (FMD) were significantly lower after HSCT as compared to the results obtained before the transplantation (p \ 0.05)
The precise description of the applied protocol of the study was presented in previous article of the authors, which was concentrating on the heart rate variability and heart rate turbulence in patients with hematologic malignancies undergoing high-dose chemotherapy followed by hematopoietic stem cell transplantation [3]
Summary
Hematopoietic stem cell transplantation (HSCT) is an important therapeutic strategy in many hematologic malignancies and significantly prolongs survival in patients. Clinical observations suggest that cardiovascular complications may appear in some patients in the course of peripheral blood stem cell transplantation and there is a serious risk of developing some long-term complications. The detailed range of possible cardiovascular complications and potential cardiotoxic effects of the stem cell administration in individual groups of patients remains unknown. Our previous studies showed that in patients with hematopoietic malignancies undergoing HSCT, after chemotherapy and stem cell administration, the decreased heart rate variability and heart rate turbulence were observed [3]. It is known that impaired endothelial function plays an important role in the pathophysiology of atherosclerotic cardiovascular diseases [4]. Assessment of flow-mediated dilatation (FMD) is one of the possible functional and noninvasive methods. FMD is the assessment of brachial artery reactivity to hyperemia induced by compression [5]
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