EVALUATION OF SYSTOLIC DYSFUNCTION IN PATIENTS WITH LYMPHOPROLIFERATIVE DISORDERS AFTER STEM CELL TRANSPLANT: A SINGLE CENTER EGYPTIAN EXPERIENCE.

Background: The long-term prognosis after Hematopoietic stem cell transplantation (HSCT) has greatly improved. However, HSCT survivors are at risk of developing long term complications. Cardiac complications are potentially life-threatening and there is a need to elucidate the incidence, severity and underlying mechanisms of these complications. We assessed the systolic cardiac function by echocardiography in patients who underwent autologus and allogeneic hematopoietic stem cell transplantation for lymphoproliferative disorders and evaluated the association between the conditioning regimens used and the decline in ejection fraction. Materials and methods: 100 patients were enrolled in this retrospective study, 72 patients underwent autologus and 21 patients underwent allogeneic stem cell transplantation. 39 patients had multiple myeloma, 30 patients had NHL, 21 patients had acute lymphoblastic lymphoma, 10 patients had HD. LVEF was assessed by echocardiography and compared to a healthy control group as well as 50 positive control of patients who received chemotherapy without undergoing transplant. Results: The mean ejection fraction of cases after transplant is significantly reduced compared to the negative control group, The ejection fraction decline was highly pronounced in older age groups, male patients and more in patients with larger surface area, with the use of TBI-based regimens followed by patients who received high-dose cyclophosphamide in the conditioning regimens. Conclusion: LVEF was reduced in patients with lymphoproliferative disorders after autologus and allogeneic hematopoietic stem cell transplantation and was correlated with the use of TBI-based conditioning regimens and high-dose cyclophosphamide.