Allogeneic peripheral blood stem cell transplantation and accelerated atherosclerosis: An intriguing association needing targeted surveillance. Lessons from a rare case of acute anterior myocardial infarction.
Autor: Scudiero, Laura; Soriano, Francesco; Morici, Nuccia; Grillo, Giovanni; Belli, Oriana; Sacco, Alice; Cipriani, Manlio; Pedrotti, Patrizia; Quattrocchi, Giuseppina; Klugmann, Silvio; Oliva, Fabrizio
Publication year: 2020
European heart journal. Acute cardiovascular care
issn:2048-8734 2048-8726
doi: 10.1177/2048872616652311
Abstract:
We report the case of a 23-year-old man who developed an acute ST-elevation myocardial infarction secondary to acute thrombotic occlusion of the proximal left anterior descending coronary artery five years after undergoing chemotherapy, radiotherapy, haematopoietic stem cell transplantation for acute lymphoblastic leukaemia and bulky mediastinal mass involving the pleura and pericardium. His medical history also included Graft versus Host Disease developed 13 months after transplantation and acute myocarditis three months before the actual hospital admission. To the best of our knowledge, coronary artery disease as a complication of haematopoietic stem cell transplantation and low-dose mediastinal radiation therapy in young patients has been rarely reported in the medical literature. Clinicians should have a high degree of suspicion of coronary artery disease in patients treated with allogeneic haematopoietic stem cell transplantation, especially in patients previously treated with target mediastinal radiotherapy, as a group at risk of premature and significantly accelerated atherosclerosis, in order to make a timely and correct diagnosis.
Language: eng
Rights:
Pmid: 27221956
Tags: Humans; Male; Young Adult; Risk Factors; Coronary Angiography; Atherosclerosis/*complications/diagnosis; Blood-transplantation; cardiovascular risk factors; chemotherapy; coronary artery disease; Electrocardiography; Graft versus Host Disease; Peripheral Blood Stem Cell Transplantation/*adverse effects; Precursor Cell Lymphoblastic Leukemia-Lymphoma/*surgery; radiation therapy; ST Elevation Myocardial Infarction/diagnosis/*etiology
Link: https://pubmed.ncbi.nlm.nih.gov/27221956/