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Review
. 2023 Jun;8(2):87-100.
doi: 10.1177/23971983221145639. Epub 2023 Feb 7.

Cardiotoxicity in autologous haematopoietic stem cell transplantation for systemic sclerosis

Ross Penglase  1   2   3 , Laila Girgis  1   2   3 , Helen Englert  4 , Xavier Brennan  5 , Andrew Jabbour  2   5 , Eugene Kotlyar  2   5 , David Ma  2   3   4 , John Moore  2   3   4
Affiliations
Review

Cardiotoxicity in autologous haematopoietic stem cell transplantation for systemic sclerosis

Ross Penglase et al. J Scleroderma Relat Disord. 2023 Jun.

Abstract

Autologous haematopoietic stem cell transplantation is now well-established as an effective treatment for severe systemic sclerosis with clear demonstration of favourable end-organ and survival outcomes. Treatment-related cardiotoxicity remains the predominant safety concern and contraindicates autologous haematopoietic stem cell transplantation in patients with severe cardiopulmonary disease. In this review, we describe the cardiovascular outcomes of autologous haematopoietic stem cell transplantation recipients, discuss the potential mechanisms of cardiotoxicity and propose future mitigating strategies.

Keywords: Scleroderma; autologous haematopoietic stem cell transplantation; cardiac; safety; stem cell transplantation; systemic sclerosis; toxicity.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Figure 1.
Figure 1.
Putative mechanisms of (in boxes), and mitigating strategies for preventing cardiotoxicity in SSc patients receiving AHSCT with cyclophosphamide conditioning. SSc-HI leads to impaired myocardial reserve that increases the risk of cardiotoxicity. PAH pulmonary artery hypertension; LV left ventricular; RV right ventricular; ACEi angiotensin converting enzyme inhibitor; ARB angiotensin II receptor blocker; AHSCT autologous haematopoietic stem cell transplantation; CYC cyclophosphamide; IBW ideal body weight; BSA body surface area.
Figure 2.
Figure 2.
Manifestations and prevalence of cardiac disease and PAH in systemic sclerosis. PAH pulmonary arterial hypertension.
See this image and copyright information in PMC

References

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