Stem cell mobilization effects on heart sizes and function

Abstract

Background: Hematopoietic stem cell transplantation (HSCT) can cause cardiac toxicity of different grade. In this study we aimed to evaluate the impact of mobilization procedure for autologous HSCT process on left and right ventricle sizes and systolic function. Methods: Data of 35 patients undergoing autologous HSCT at the Department of Oncology and Hematology in the Hospital of Lithuanian University of Health Sciences Kaunas Clinics from October 2021 till Feb 2023 were analyzed. Bioethics approvement for prospective study was obtained (No BE-2-96). HSCT was performed for various reasons – mostly multiple myeloma, also mantle cell lymphoma, Hodgkin lymphoma, diffuse large B cell lymphoma, Ewing sarcoma. All patients underwent hematopoietic stem cell mobilization with chemotherapy and filgrastim 10 µg/kg/d. Echocardiography was performed before enrolling to the transplantation process and after mobilization before the conditioning regimen. Left ventricular end diastolic diameter (LVEDD), LVEDD index according to body surface area (BSA) (LVEDDi), left ventricular ejection fraction (LV EF), left ventricular global longitudinal strain (GLS), right ventricle (RV) end diastolic diameter (RVEDD, tricuspid annular systolic velocity (S’) using tissue doppler and tricuspid annular plane systolic excursion (TAPSE) were measured before and after mobilization and compared. Statistical analysis was performed using SPSS statistics 20. Qualitative data is presented as an absolute value (N) and percentage (%), quantitative parameters are given as average (m ± standard deviation). We used paired- samples T test to compare quantitative parameters. Statistically significant difference was considered when p<0.05. Results: Out of 35 patients there were 18 men (51,4%) and 17 women (48,6%). Mean age was 57,4±13,15 years, ranging from 18 to 74. 26 (74,3%) patients had multiple myeloma, 4 (11,4%) mantle cell lymphoma, 2 (5,7%) Hodgkin ‘s lymphoma, 2 (5,7%) PCNS diffuse large B cell lymphoma, 1 (2,9%) Ewing sarcoma. Statistically significant difference was observed in the change of RV function. S‘ and TAPSE slightly decreased. Changes of echocardiographic parameters are presented in Table 1. Conclusions: Mobilization procedure in patients undergoing autologous HSCT is associated with reduced RV systolic function. S‘ and TAPSE might be used for early cardiotoxicity evaluation in HSCT patients.