Book contents
- Frontmatter
- Contents
- Acknowledgments
- Contributor
- 1 Rationale for transplantation
- 2 Types of transplantation
- 3 Human leukocyte antigen matching in allogeneic transplantation
- 4 Stem cell source
- 5 Pretransplant evaluation and counseling of patient and donor
- 6 Conditioning regimens
- 7 Stem cell infusion
- 8 ABO compatibility
- 9 Engraftment
- 10 Preventative care
- 11 Transplant-related complications
- 12 Overview of acute and chronic graft-versus-host disease
- 13 Acute graft-versus-host disease and staging
- 14 Graft-versus-host disease prophylactic regimens
- 15 Treatment guidelines for acute graft-versus-host disease
- 16 Chronic graft-versus-host disease
- 17 Engraftment syndrome
- 18 Infectious disease
- 19 Graft rejection and failure
- 20 Gastrointestinal complications
- 21 Oral health in stem cell transplantation
- 22 Pulmonary complications
- 23 Veno-occlusive disease
- 24 Special transfusion-related situations
- 25 Cardiovascular complications
- 26 Neurologic complications
- 27 Cystitis
- 28 Donor lymphocyte infusion
- 29 Transplantation: regulation and accreditation
- Index
25 - Cardiovascular complications
Published online by Cambridge University Press: 05 November 2013
- Frontmatter
- Contents
- Acknowledgments
- Contributor
- 1 Rationale for transplantation
- 2 Types of transplantation
- 3 Human leukocyte antigen matching in allogeneic transplantation
- 4 Stem cell source
- 5 Pretransplant evaluation and counseling of patient and donor
- 6 Conditioning regimens
- 7 Stem cell infusion
- 8 ABO compatibility
- 9 Engraftment
- 10 Preventative care
- 11 Transplant-related complications
- 12 Overview of acute and chronic graft-versus-host disease
- 13 Acute graft-versus-host disease and staging
- 14 Graft-versus-host disease prophylactic regimens
- 15 Treatment guidelines for acute graft-versus-host disease
- 16 Chronic graft-versus-host disease
- 17 Engraftment syndrome
- 18 Infectious disease
- 19 Graft rejection and failure
- 20 Gastrointestinal complications
- 21 Oral health in stem cell transplantation
- 22 Pulmonary complications
- 23 Veno-occlusive disease
- 24 Special transfusion-related situations
- 25 Cardiovascular complications
- 26 Neurologic complications
- 27 Cystitis
- 28 Donor lymphocyte infusion
- 29 Transplantation: regulation and accreditation
- Index
Summary
Myopericarditis
Cyclophosphamidecardiotoxicity is idiosyncratic and independent of baseline cardiacfunction. When used in high doses, cyclophosphamide can inducemyopericarditis that can be associated with pericardial tamponade orpulseless electrical activity (PEA) arrest and death. Milder forms may leadto congestive heart failure, requiring appropriate therapy. More common isthe development of myocardial edema that can result in reduction inelectrocardiogram (ECG) voltage but no functional consequences.
Clinical manifestations
Shortness of breath, chest discomfort (often pleuritic and improved with sitting up), cough, fever, tachycardia.
Diagnosis
Pericardial rub, ST segment elevation, PR depression.
Echocardiogram may show fluid; with impending tamponade, may also have diastolic indentation or collapse of the right ventricle. Aspiration under l uoroscopic guidance may be required for presumed infectious or malignant etiologies.
Treatment
If manifestations are mild, supportive care is usually adequate.
Nonsteroidal anti-inl ammatory drugs (NSAIDS) are not used in patients with thrombocytopenia. Colchicine may be helpful in some patients.
If cyclophosphamide is the presumed etiology, there is no specific therapy.
If the underlying problem is infectious or malignant it is treated specifically.
Pericardiocentesis or a pericardial window if tamponade develops.
- Type
- Chapter
- Information
- Manual of Stem Cell and Bone Marrow Transplantation , pp. 170 - 171Publisher: Cambridge University PressPrint publication year: 2013