Acute systolic dysfunction within two weeks of high-dose chemotherapy conditioning before autologous bone marrow transplant: a case report

Echocardiography. 2008 Aug;25(7):764-7. doi: 10.1111/j.1540-8175.2008.00691.x. Epub 2008 May 7.

Abstract

Studies have shown various cardiotoxic effects of high-dose chemotherapy (HDC) used for conditioning before autologous bone marrow transplant (ABMT) including arrhythmias but only a transient small decrease in left ventricle ejection fraction (LVEF). To our knowledge, an acute dramatic decrease in LVEF after HDC preconditioning has never been reported. We report a patient presenting with an acutely symptomatic heart failure within 2 weeks of receiving HDC conditioning for ABMT with an LVEF drop from normal to <30%. With stringent management and follow-up with regular echocardiograms for medication reconciliation, 5 months later she regained her LVEF of 50%.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bone Marrow Transplantation / adverse effects
  • Bone Marrow Transplantation / methods*
  • Cardiac Output
  • Cyclophosphamide / adverse effects
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Echocardiography, Doppler
  • Female
  • Follow-Up Studies
  • Heart Failure, Systolic / chemically induced*
  • Heart Failure, Systolic / diagnostic imaging
  • Humans
  • Lymphoma, Large B-Cell, Diffuse / pathology
  • Lymphoma, Large B-Cell, Diffuse / surgery*
  • Middle Aged
  • Recovery of Function
  • Risk Assessment
  • Severity of Illness Index
  • Stroke Volume
  • Time Factors
  • Transplantation Conditioning / adverse effects*
  • Transplantation Conditioning / methods
  • Transplantation, Autologous
  • Ventricular Dysfunction, Left / chemically induced
  • Ventricular Dysfunction, Left / diagnostic imaging

Substances

  • Cyclophosphamide